Surgical access device

ABSTRACT

The present invention generally provides methods and devices for removing fluid from a surgical instrument. Surgical access devices and seal systems are generally provided having one or more valves or seal assemblies to create a closed system between the outside environment and the environment in which the surgical access device is being inserted. The devices of systems can also include a fluid remover in the form of a sorbent element, a scraper element, a wicking element, or any combination thereof that is configured to remove fluid from a working channel of the device or system and/or from a surgical instrument inserted therethrough.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/823,345, filed on Nov. 27, 2017 and entitled “Surgical AccessDevice,” which is a continuation of U.S. patent application Ser. No.14/150,256 (now U.S. Pat. No. 9,827,383), filed on Jan. 8, 2014 andentitled “Surgical Access Device,” which is a continuation of U.S.patent application No. 12/902,265 (now U.S. Pat. No. 8,636,686), filedon Oct. 12, 2010 and entitled “Surgical Access Device,” which is acontinuation-in-part of U.S. patent application Ser. No. 12/533,590 (nowU.S. Pat. No. 8,568,362), filed on Jul. 31, 2009 and entitled “SurgicalAccess Devices with Sorbents,” which is a continuation-in-part of: U.S.patent application Ser. No. 12/110,724 (Now U.S. Pat. No. 8,579,807),filed on Apr. 28, 2008 and entitled “Absorbing Fluids in a SurgicalAccess Device,” U.S. patent application Ser. No. 12/110,727 (now U.S.Pat. No. 8,870,747) filed on Apr. 28, 2008 and entitled “Scraping FluidRemoval in a Surgical Access Device,” U.S. patent application Ser. No.12/110,742 (now U.S. Pat. No. 9,358,041), filed on Apr. 28, 2008 andentitled “Wicking Fluid Management in a Surgical Access Device,” andU.S. patent application Ser. No. 12/110,755 (Now U.S. Pat. No.8,273,060), filed on Apr. 28, 2008 and entitled “Fluid Removal in aSurgical Access Device,” all of which are hereby incorporated byreference in their entireties.

FIELD OF THE INVENTION

The present invention relates to methods and devices for performingsurgical procedures, and in particular to methods and devices formaintaining visibility during surgical procedures.

BACKGROUND OF THE INVENTION

During laparoscopic surgery, one or more small incisions are formed inthe abdomen and a trocar is inserted through the incision to form apathway that provides access to the abdominal cavity. The trocar is usedto introduce various instruments and tools into the abdominal cavity, aswell as to provide insufflation to elevate the abdominal wall above theorgans. During such procedures, a scoping device, such as an endoscopeor laparoscope, is inserted through one of the trocars to allow asurgeon to view the operative field on an external monitor coupled tothe scoping device.

Scoping devices are often inserted and removed through a trocar multipletimes during a single surgical procedure, and during each insertion andeach removal they can encounter fluid that can adhere to the scopes lensand fully or partially impede visibility through the lens. Furthermore,a scope can draw fluid from inside or outside a patients body into thetrocar, where the fluid can be deposited within the trocar until thescope or other instrument is reinserted through the trocar. Uponreinsertion, fluid can adhere to the scopes lens. The scopes lens thusneeds to be cleaned to restore visibility, often multiple times during asingle surgical procedure. With limited access to a scope in a body,each lens cleaning can require removing the scope from the body,cleaning the scope lens of fluid, and reintroducing the scope into thebody. Such lens cleaning is a time-consuming procedure that alsoincreases the chances of complications and contamination throughrepeated scope insertion and removal.

Accordingly, there is a need for methods and devices for maintainingclear visibility through a lens of a scoping device during a surgicalprocedure.

SUMMARY OF THE INVENTION

The present invention generally provides methods and devices forpreventing fluid deposit onto and/or for removing fluid from a surgicalinstrument. In one embodiment, a surgical access device is provided andcan include a housing defining a working channel sized and configured toreceive a surgical instrument. An insufflation port can be formed in thehousing and it can be configured to deliver an insufflation gas to theworking channel. Further, a seal can be disposed within the housing andit can be positioned proximal to the insufflation port. In someembodiments, the seal can be configured to receive a surgical instrumentpassed through the working channel.

A fluid remover can be disposed within the housing and it can bepositioned distal to the insufflation port. The fluid remover can havemany configurations, for example, the fluid remover can have an outerperimeter mounted within the housing and a central opening configured toreceive surgical instruments therethrough. In some embodiments, theouter perimeter can be in sealing engagement with the housing. The fluidremover can be configured to allow insufflation gas to pass therethroughwhen an instrument occludes the central opening. The fluid remover canbe, for example, a scraper configured to scrape fluid away from surgicalinstruments inserted through the central opening.

In some embodiments, the scraper can include a wicking element formedthereon and configured to wick fluid away from the central opening inthe scraper. The wicking element can have many different configurations,for example, the wicking element can be in the form of a plurality ofchannels formed in a distal surface of the scraper and extendingradially outward from the central opening such that fluid scraped off ofa surgical instrument can flow into the channels. The fluid remover canalso include a sorbent disposed distal to the scraper and configured toreceive fluid scraped by the scraper. In one embodiment, the fluidremover can include a hole formed therein and positioned a distance awayfrom the central opening and the outer perimeter. The hole can beconfigured to allow insufflation gas to pass therethrough.

As will be appreciated by those having ordinary skill in the art, thehousing can have many configurations. In one embodiment, the housing caninclude a proximal housing portion and a distal housing portion having acannula extending distally therefrom. The proximal and distal housingportions can be disposed around an inner retainer, and the workingchannel can extend through the inner retainer and the cannula. The outerperimeter of the fluid remover can be in sealing engagement with theinner retainer and the distal housing portion. In some embodiments, theseal can be captured between the inner retainer and the proximal housingportion.

The distal cannula can include an angled distal surface having adistal-most point and a proximal-most point. In some embodiments, thedistal-most point can be aligned with the insufflation port, although itcan have any angular orientation as desired. The surgical access devicecan also include at least one opening formed on an outside wall of thehousing that can be configured for receiving suture.

In other aspects, a surgical access device is provided and can include ahousing and a cannula extending distally from the housing. The housingand the cannula can have a working channel extending therethroughbetween a proximal opening formed in a proximal end of the housing and adistal end of the cannula. The working channel can be sized andconfigured to receive a surgical instrument. An insufflation port can becoupled to the housing and configured to receive and deliver aninsufflation gas to the working channel. Further, a seal can be disposedwithin the housing and configured to substantially prevent passage of aninsufflation gas from the insufflation port to the proximal opening whenno surgical instrument is disposed therethrough.

In some embodiments, a fluid remover can be disposed within the housingand can be positioned distal of the seal. The fluid remover can have anouter perimeter in sealing engagement with the housing. The fluidremover can also have a central opening formed therethrough positionedto receive a surgical instrument passed through the working channel.Further, the fluid remover can include a hole formed therein between thecentral opening and the outer perimeter that is configured to allowinsufflation gas to pass from the insufflation port to the cannula whenan instrument is disposed through and occludes the central opening inthe fluid remover.

While the fluid remover can have many configurations, in one embodiment,the fluid remover can be a scraper configured to scrape fluid off of asurgical instrument passed through the opening. The surgical accessdevice can also include a sorbent disposed within the housing at alocation distal to the scraper. The sorbent can be configured to sorbfluid removed by the scraper. In some embodiments, the surgical accessdevice can further include a wicking element formed on the scraper andconfigured to wick fluid away from the central opening in the scraper.The sorbent can have, for example, a central opening formed therethroughand can be axially aligned with the central opening in the scraper. Inone embodiment, the central opening in the sorbent can have a diametergreater than a diameter of the central opening in the scraper. Theinsufflation port can be positioned anywhere within the housing, forexample, the insufflation port can be positioned proximal to the fluidremover.

While the housing can have many configurations, in one embodiment, thehousing can include a proximal housing portion and a distal housingportion disposed around an inner retainer. The working channel canextend through the inner retainer, and the outer perimeter of the fluidremover can be in sealing engagement with the inner retainer. Theproximal opening can be formed in the proximal housing. In someembodiments, the inner retainer can be captured between the proximal anddistal housing portions.

In further aspects, methods are also provided. For example, a method forremoving fluid from a surgical access device is provided and can includeinserting a surgical access device through tissue such that the surgicalaccess device provides a working channel extending through the tissueand into a body cavity. Further, a surgical instrument can be insertedthrough the working channel of the surgical access device such that acentral opening formed in a scraper disposed within the working channelengages a circumference of the surgical instrument. The method canfurther include delivering an insufflation gas through an insufflationport in the surgical access device to insufflate the body cavity. Theinsufflation gas can pass through a hole formed in the scraper.

In some embodiments, inserting a surgical instrument through the workingchannel of a surgical access device can include inserting a surgicalinstrument through a seal in a working channel of a surgical accessdevice extending into a body cavity. The seal can move from a closedposition in which the working channel is sealed to an open position asthe surgical instrument is passed therethrough. Further, a fluid removerdisposed distal of the seal can scrape fluid from the surgicalinstrument and invert proximally to transfer the fluid away from thesurgical instrument. Fluid scraped by the scraper can be transferred toa sorbent.

In other aspects, a method for reprocessing a surgical access device isprovided and includes removing a scraper from a surgical access device,cleaning the scraper, treating a surface of the scraper with asurfactant, and replacing the scraper in the surgical access device. Insome embodiments, the surfactant can be dodecylbenzene sodium sulfonateor sodium dodecyl sulfate. In other embodiments, the scraper can beformed from a hydrophobic material such as a polyisoprene.

In still further aspects, a method for reprocessing a surgical accessdevice is provided and includes removing a first sorbent from a surgicalaccess device, treating a second sorbent with a surfactant, andreplacing the first sorbent with the second sorbent in the surgicalaccess device. In some embodiments, the surfactant can be dodecylbenzenesodium sulfonate or sodium dodecyl sulfate.

In another aspect, a fluid remover for use in a surgical access deviceis provided and can include a housing defining a working channel sizedto receive a surgical instrument, an insufflation port disposed in thehousing, and a seal disposed proximal to the insufflation port. In someembodiments, the fluid remover can include a fluid removing memberhaving an outer perimeter and a central opening formed therein forreceiving and sealing around a surgical access device. The fluidremoving member can also have a hole disposed radially outward from thecentral opening and radially inward from the outer perimeter and can beconfigured to allow insufflation gas to pass therethrough.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1A is a perspective view of one embodiment of a trocar;

FIG. 1B is an exploded view of the trocar of FIG. 1A;

FIG. 1C is a cross-sectional view of a portion of the trocar of FIG. 1A;

FIG. 1D is a bottom perspective view of an instrument seal assembly foruse with the trocar of FIG. 1A;

FIG. 1E is an exploded view of the instrument seal assembly of FIG. 1D;

FIG. 1F is a perspective view of a channel seal of the trocar of FIG.1A;

FIG. 1G is a bottom perspective view of one embodiment of a scraper of afluid remover assembly for use with the trocar of FIG. 1A;

FIG. 1H is a perspective view of one embodiment of a sorbent wick of afluid remover assembly for use with the trocar of FIG. 1A;

FIG. 1I is a perspective view of a sorbent element of a fluid removerassembly for use with the trocar of FIG. 1A;

FIG. 1J is a perspective view of a frame for housing the sorbent elementof FIG. 1I;

FIG. 1K is a perspective view of a lid portion of a fluid removerassembly for use with the trocar of FIG. 1A;

FIG. 2A is a cross-sectional view of a proximal portion of anotherembodiment of a trocar;

FIG. 2B is an exploded view of the trocar of FIG. 2A;

FIG. 3A is an exploded view of a portion of a trocar having a drop-influid remover assembly;

FIG. 3B is an exploded view of the drop-in fluid remover assembly ofFIG. 3A;

FIG. 3C is a cross-sectional view of a trocar of FIG. 3A;

FIG. 4A is an exploded view of one embodiment of a scraper assembly forscraping fluid;

FIG. 4B is a bottom perspective view the scraper assembly of FIG. 4A;

FIG. 4C is a top perspective view of the scraper assembly of FIG. 4A;

FIG. 5A is a perspective view of another embodiment of fluid removerassembly having a scraper nested within a sorbent element;

FIG. 5B is top view of the fluid remover assembly of FIG. 5A;

FIG. 5C is a cross-sectional view of the fluid remover assembly of FIG.5A disposed within a trocar housing;

FIG. 6A is a cross-sectional view of a trocar having one embodiment of ascraper for scraping fluid away from a surgical instrument passedtherethrough;

FIG. 6B is a cross-sectional view of a trocar having another embodimentof a scraper for scraping fluid away from a surgical instrument passedtherethrough;

FIG. 6C is a cross-sectional view of a trocar having yet anotherembodiment of a scraper for scraping fluid away from a surgicalinstrument passed therethrough;

FIG. 7 is a cross-sectional view of another embodiment of a trocarhousing having sorbent flapper doors positioned adjacent to azero-closure seal;

FIG. 8 is a cross-sectional view of yet another embodiment of a trocarhousing having wicking fingers coupled to a sorbent reservoir;

FIG. 9 is a cross-sectional view of one embodiment of a trocar housinghaving a sorbent element disposed therein;

FIG. 10A is a cross-sectional view of one embodiment of a zero-closureseal having extension members for wicking fluid;

FIG. 10B is a transparent perspective view of the seal of FIG. 10A;

FIG. 11 is an exploded view of another embodiment of fluid removerassembly having a sorbent element nested between first and secondzero-closure seals;

FIG. 12A is a cross-sectional view of yet another embodiment of asorbent element having two sorbent bars disposed within a zero-closureseal;

FIG. 12B is a transparent perspective view of the sorbent element andseal of FIG. 12A;

FIG. 13 is an exploded view of one embodiment of a trocar housing havinga scraper for scraping fluid away from a surgical instrument passedtherethrough;

FIG. 14 is a cross-sectional view of one embodiment of a trocar caphaving a scraper for scraping fluid away from a surgical instrumentpassed therethrough;

FIG. 15A is a top view of a trocar cap having another embodiment of ascraper for scraping fluid away from a surgical instrument passedtherethrough;

FIG. 15B is a side perspective view of the trocar cap of FIG. 15A;

FIG. 16 is an exploded view of one embodiment of a multi-layer sealhaving a sorbent element disposed between the layers;

FIG. 17 is a bottom perspective view of one embodiment of a trocar caphaving a sorbent element disposed therein;

FIG. 18A is a bottom perspective view of one embodiment of a wickingelement formed on a portion of a seal protector for creating between theseal protector and a seal;

FIG. 18B is a top perspective view of the portion of the seal protectorof FIG. 18A;

FIG. 19A is a top view of a multi-layer protective member having cammingribs;

FIG. 19B is a top view of one layer of the protective member of FIG.19A;

FIG. 20A is a side perspective view of a deep cone instrument sealhaving wicking ribs formed on an external surface;

FIG. 20B is a top perspective view of another embodiment of a deep coneinstrument seal having wicking ribs formed on an internal surface;

FIG. 21 is a perspective view of a multi-layer protective element havingholes formed therein for receiving fluid;

FIG. 22A is an exploded view of a multi-layer protective element;

FIG. 22B is a cross-sectional view taken across line B-B of one of theprotective elements of FIG. 22A;

FIG. 23A is a side view of one embodiment of a seal having an hourglassconfiguration for scraping fluid off of a surgical instrument;

FIG. 23B is a side view of the seal of FIG. 23A showing an instrumentpassed therethrough;

FIG. 24A is cross-sectional view of one embodiment of a trocar cannulahaving overlapping scrapers and a sorbent disposed therein;

FIG. 24B is an enlarged view of one of the scrapers and sorbents of FIG.24A;

FIG. 25 is a perspective view of another embodiment of a scraper forscraping fluid off of a surgical instrument shown passed therethrough;

FIG. 26 is a perspective view of another embodiment of a device forscraping fluid away from a surgical instrument;

FIG. 27A is an exploded view of a trocar and removable tip for scrapingfluid away from a surgical instrument;

FIG. 27B is an assembled side view of a distal end of the trocar andremovable tip of FIG. 27A;

FIG. 27C is a perspective view of the removable tip and distal end ofthe trocar of FIG. 26B;

FIG. 28 is a partially-transparent side view of one embodiment ofwicking element having an hourglass shape;

FIG. 29 is a perspective view of a trocar having a cannula with slotsformed therein for wicking fluid out of the cannula;

FIG. 30A is a perspective view of another embodiment of a trocar havinga proximal housing and a distal cannula;

FIG. 30B is a cross-sectional side view of the trocar of FIG. 30A;

FIG. 30C is a perspective view of an instrument seal assembly, a channelseal, a fluid remover assembly, and an insufflation port of the trocarof FIG. 30A;

FIG. 30D is a cross-sectional side view of the fluid remover andinsufflation port of FIG. 30C;

FIG. 30E is a perspective view of a fluid remover of FIG. 30C;

FIG. 30F is an exploded view of the fluid remover of FIG. 30E showing alid, scraper, crown, and sorbent;

FIG. 30G is a bottom perspective view of a scraper of FIG. 30F showingchannels formed therein;

FIG. 30H is a cross-sectional view of one of the channels of the scraperof FIG. 30G;

FIG. 30I is a top view of a lid of FIG. 30F;

FIG. 30J is a bottom view of the lid of FIG. 33I; and

FIG. 31 is a bottom view of another embodiment of a lid for use with afluid remover assembly;

FIG. 32A is a perspective view of another embodiment of a trocar;

FIG. 32B is a side perspective view of an instrument seal, a channelseal, a fluid remover, and an insufflation port of the trocar of FIG.32A;

FIG. 32C is a side view of the fluid remover and insufflation port ofFIG. 32B;

FIG. 32D is a side perspective view of the fluid remover of FIG. 32C;

FIG. 33A is a perspective view of another embodiment of a trocar havinga fluid removing system disposed therein;

FIG. 33B is a cross-sectional view of the trocar of FIG. 33A showing anexemplary seal system and fluid removal system;

FIG. 34A is a perspective view of one embodiment of a proximal housingof the trocar of FIG. 33A;

FIG. 34B is another perspective view of the proximal housing of FIG.34A;

FIG. 35A is a perspective view of one embodiment of a distal housing ofthe trocar of FIG. 33A;

FIG. 35B is a perspective cross-sectional view of the distal housing ofFIG. 35A;

FIG. 36 is an exploded view of the seal system and fluid removal systemof the trocar of FIG. 33A;

FIG. 37A is a perspective view of an exemplary seal retainer of thetrocar of FIG. 33A;

FIG. 37B is a cross-sectional view of the seal retainer of FIG. 37A;

FIG. 37C is a perspective view of another exemplary seal retainer foruse in the trocar of FIG. 33A;

FIG. 38A is a bottom view of an exemplary scraper and wicking elementfor use in the trocar of FIG. 33A;

FIG. 38B is a top view of the scraper of FIG. 38A;

FIG. 38C is a top view of the scraper of FIG. 38A seated within anexemplary distal housing; and

FIG. 39 is a perspective view of an exemplary sorbent for use in thetrocar of FIG. 33A.

DETAILED DESCRIPTION OF THE INVENTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

The present invention generally provides methods and devices formaintaining clear visibility through a scoping device during surgicalprocedures, and in particular methods and devices are provided forremoving fluid from an access device and/or surgical instrument passed,e.g., inserted and/or withdrawn, through an access device, and/or forpreventing fluid from being transferred onto a scoping device passedthrough an access device. In certain exemplary embodiments, the methodsand devices are effective to remove fluid from an access device and/orsurgical instrument as the instrument is being withdrawn from the accessdevice, thus preventing the fluid from being deposited onto aninstrument being inserted through the access device. However, themethods and devices can be configured to remove fluid prior to and/orduring insertion and/or removal.

A person skilled in the art will appreciate that the term fluid as usedherein is intended to include any substance that, when on a surgicalinstrument, can adversely affect the functioning of the instrument or asurgeon's ability to use it. Fluids include any kind of bodily fluid,such as blood, and any kind of fluid introduced during a surgicalprocedure, such as saline. Fluids also include fluid/solid mixtures orfluids with particles (such as pieces of tissue) suspended or locatedtherein, as well as viscous materials and gases. A person skilled in theart will also appreciate that the various concepts disclosed herein canbe used with various surgical instruments during various procedures, butin certain exemplary embodiments the present invention is particularlyuseful during laparoscope procedures, and more particularly duringprocedures in which a scoping device, such as an laparoscope orendoscope, is passed through a surgical access device, such as a trocar,that provides a pathway from a skin incision to a body cavity. Aspreviously explained, during such procedures repeated insertion andwithdrawal of the scoping device can deposit fluid within the accessdevice, thus allowing the fluid to be transferred back onto the distalviewing end of the scoping device upon reinsertion therethrough. Variousexemplary methods and devices are provided herein to prevent such anoccurrence.

In certain exemplary embodiments, the methods and devices disclosedherein utilize a fluid remover that is effective to remove fluid from anaccess device and/or surgical instrument passed therethrough. While thefluid remover can have various configurations and it can function invarious manners to remove fluid, exemplary fluid removers includescrapers for scraping fluids, sorbents for sorbing fluid, and wickingelements for redirecting or wicking fluid away, e.g., by capillaryaction. Any combination of fluid removers can be provided, and the fluidremovers can be disposed at various locations within an access device toremove fluid from portions of the access device and/or from surgicalinstruments, such as scoping devices, passed through the access device.The particular location of the fluid remover(s) can depend on theparticular configuration of the access device and/or surgicalinstrument.

In certain exemplary embodiments, the fluid remover can include one ormore sorbents. The sorbent can be any insoluble (or at least partiallyinsoluble) material or mixture of materials that are capable of sorbingfluids or taking up fluids through a process of one or both ofabsorption and adsorption. A sorbent material or element can thusinclude any one of or combination of absorbent materials and/or elementsand adsorbent materials and/or elements. In certain exemplaryembodiments, the sorbent is formed from a hydrophilic material and/orincludes a hydrophilic material to facilitate fluid receipt. Forexample, the sorbent can be coated using known coating techniques duringmanufacturing to render one or more portions of the sorbent hydrophilic.In one embodiment, the sorbent can be formed by an extrusion process inwhich, for example, the fibers can all extend longitudinally in adirection generally parallel to a longitudinal axis of the cylindricaltube, as shown in FIG. 30F. The fibers will thus form a generallycylindrical, hollow tubular member, which can subsequently be cut toform a plurality of sorbents. A sidewall gap or cut-out can also be madeto form a C-shaped sorbent, or the sorbent can be formed to have aC-shaped configuration without the need to make any additional cuts.Exemplary shapes and configurations for the sorbent will be discussed inmore detail below. A hydrophilic surfactant can be applied to thesorbent, either prior to or after the sorbent is cut. A person skill inthe art will appreciate that a variety of techniques can be used to coatthe sorbent or portions thereof with a hydrophilic material and/or toform the sorbent or portions thereof from a hydrophilic material. Theparticular hydrophilic material used can also vary, and exemplarymaterials will be discussed in more detail below with respect to thescraper. The same hydrophilic materials used with the scraper can alsoor alternatively be used with the sorbent.

In general, sorbents that are absorbents remove fluid through a processof absorption, similar to a sponge, in which a liquid diffuses into thevolume and/or structure of the absorbent and becomes a part of thatvolume and/or structure. For example, the sorbent can pick up and retaina liquid distributed throughout its molecular structure causing theabsorbent to swell. The liquid can cause the solid structure to swell50% of more. Typical absorbents are at least 70% insoluble in excessfluid. Absorbents can have any shape, size, and form known in the art asneeded to stand alone and/or fit within, around, or throughout anycomponent of a fluid remover and/or trocar. Certain exemplaryembodiments of absorbents include, but are not limited to, comminutedwood pulp fluff, cellulose fibers, polymeric gelling agents, hydrophilicnon-wovens, cellulose, sodium polycrylate, cotton, polyethyleneterephthalate, polyethylene, polypropylene, polyvinyl chloride, ABS,polyamide, polystyrene, polyvinyl alcohol, polycarbonate,ethylene-methacrylate copolymer, and polyacetal.

Sorbents that are adsorbents, on the other hand, remove fluid through aprocess of adsorption by retaining a liquid on their surface includingpores and capillaries. Liquid accumulates on the surface of an adsorbentby forming a film of molecules or atoms that are retained thereon as aconsequence of surface energy. In some embodiments, an adsorbentmaterial can include one or more insoluble materials (or at leastpartially insoluble) that can be coated by a liquid on their surface.For example, the adsorbent can be a structure formed from insolublefibers. The structure can be porous, as voids or spaces can be locatedbetween the individual fibers. Thus, liquid can accumulate on thesurface of the fibers, thereby filling the voids between the fibers.Typical adsorbents will adsorb fluid without swelling more than 50% inexcess liquid. Adsorbents can have any shape, size, and form known inthe art as needed to stand alone and/or fit within, around, orthroughout any component of a fluid remover and/or trocar. In anexemplary embodiment, the adsorbent is molded to have a predeterminedshape and size. Certain exemplary adsorbent materials include, but arenot limited to, oxygen-containing compounds, carbon-based compounds,and/or polymer based compounds, among others. For example, adsorbentmaterials can include silica gels, alumina, zeolites, activated carbon,graphite, cellulose, porous polymer matrices, perlite, metal hydroxides,metal oxidesellulose acetate, -butyrate and -nitrate, polyamide,polysulfone, vinyl polymers, polyesters, polyolefines and PTFE, as wellas porous glass or glass ceramics, graphite oxide, polyelectrolytecomplexes, alginate gel, etc.

While the fluid removers disclosed herein can be used with varioussurgical access devices known in the art, in certain exemplaryembodiments a trocar is provided having one or more fluid removersdisposed therein for removing fluid from portions of the trocar and/orfrom an instrument, such as a scoping device, passed therethrough. Aperson skilled in the art will appreciate that a trocar is shown forillustration purposes only, and that virtually any type of accessdevice, including cannulas, ports, etc., can be used. FIGS. 1A-1Cillustrate one exemplary embodiment of a trocar 2. As shown, the trocar2 is generally in the form of a housing 6 having a proximal portion(also referred to herein as a proximal housing) that can house one ormore sealing elements and a distal cannula 8 extending distally from theproximal housing 6. The trocar 2 defines a working channel 4 extendingtherethrough for introducing various instruments into a body cavity. Anumber of configurations are available for the proximal housing 6. Inthe illustrated embodiment, the proximal housing 6 has a generallycylindrical shape with a removable cap portion 5 and an inner sidewall3. An opening 7 can be formed in the proximal end of the housing 6, suchthat the opening 7 extends through the removable cap 5 and through theremainder of the housing 6 and is coaxial with the working channel 4extending through the cannula 8. The cannula 8 can also have variousconfigurations, and can include various features known in the art. Inthe illustrated embodiment, the cannula 8 has a generally elongatecylindrical shape and includes a series of annular ridges 9 formed on anexternal surface 10 thereof. The opening 7 extending through theproximal housing 6 and the cannula 8 define the working channel 4 thatis sized and configured to receive a surgical instrument. One skilled inthe art will appreciate that the housing 6 and the cannula 8 can beformed as a unitary structure or as two separate components that aremated to one another. The housing 6 can also include other features,such as a stop-cock valve 13 for allowing and preventing the passage ofan insufflation fluid, e.g. carbon dioxide, through the trocar 2 andinto a body cavity.

In use, the distal cannula 8 can be inserted through a skin incision andthrough tissue to position a distal-most end within a body cavity. Theproximal housing 6 can remain external to the body cavity, and variousinstruments can be inserted through the working channel 4 and into thebody cavity. Typically, during surgical procedures in a body cavity,such as the abdomen, insufflation is provided through the trocar 2 toexpand the body cavity to facilitate the surgical procedure. Thus, inorder to maintain insufflation within the body cavity, most trocarsinclude at least one seal disposed therein to prevent air from escaping.Various seal configurations are known in the art, but typically thetrocar 2 includes an instrument seal that forms a seal around aninstrument disposed therethrough, but otherwise does not form a sealwhen no instrument is disposed therethrough; a channel seal (alsoreferred to herein as a zero-closure seal) that seals the workingchannel 4 when no instrument is disposed therethrough; or a combinationinstrument seal and channel seal that is effective to both form a sealaround an instrument disposed therethrough and to form a seal in theworking channel 4 when no instrument is disposed therethrough. In theembodiment shown in FIGS. 1A-1C the trocar 2 includes an instrument seal14 and a separate channel or zero-closure seal 24. However, a personskilled in the art will appreciate that various other seals known in theart can be used including, for example, flapper valves, gel seals,diaphragm seals, etc.

In an exemplary embodiment, as shown in FIGS. 1C-1E, the instrument seal14 is generally in the form of a multi-layer conical seal 16 and amulti-layer protective member 18 disposed on a proximal surface 15 ofthe seal 16. As best shown in FIG. 1E, the multi-layer conical seal 16can include a series of overlapping seal segments 20 that are assembledin a woven arrangement to provide a complete seal body. The sealsegments 20 can be stacked on top of one another or woven together in anoverlapping fashion to form the multi-layer seal 16 having a centralopening 17 therein. The seal segments 20 can be made from any number ofmaterials known to those skilled in the art, but in an exemplaryembodiment the seal segments 20 are formed from an elastomeric material.The seal segments 20 can also be molded such that they have a varyingthickness across the profile of the seal 16. Varying the thicknessacross to the profile of the seal 16 can be effective to minimizeleakage and reduce drag forces on the instrument. The multi-layerprotective member 18 can similarly be formed from a series ofoverlapping segments 22 that are disposed proximal to the overlappingseal segments 20 and that are configured to protect the seal segments 20from damage caused by surgical instruments passed through the opening 17in the seal 16. The protective member 18 can also be formed from variousmaterials, but in certain exemplary embodiments the protective member 18is formed from a molded thermoplastic polyurethane elastomer, such asPellethane™. The segments 20, 22 that form the seal 16 and theprotective member 18 can be held together using various techniques knownin the art. As shown in FIGS. 1D and 1E, the segments 20, 22 are heldtogether by several ring members that mate to engage the segments 20, 22therebetween. In particular, the protective member 18 is engaged betweena crown 26 and a gasket ring 28, and the seal 16 is engaged between thegasket ring 28 and a retainer ring 30. Pins 32 are used to mate the ringmembers 26, 28 and to extend through and engage the segments of the seal16 and protective member 18.

When fully assembled, the instrument seal 14 can be disposed at variouslocations within the trocar 2. In the illustrated embodiment, theinstrument seal 14 is disposed in the cap 5 of the trocar 2 at alocation just distal of the proximal opening 7 and proximal of a channelseal, as discussed in more detail below. In use, an instrument can bepassed through the center of the seal assembly and the seal segments 20,22 can engage and form a seal around an outer surface of the instrumentto thereby prevent the passage of fluids through the seal 14. When noinstrument is disposed therethrough, the opening will not form a seal inthe working channel 4, however other configurations in which a seal isformed when no instrument is disposed therethrough are also conceivable.Exemplary instrument seal configurations are described in more detail inU.S. Publication No. 2004/0230161 entitled “Trocar Seal Assembly,” filedon Mar. 31, 2004, and U.S. application Ser. No. 10/687,502 entitled“Conical Trocar Seal,” filed on Oct. 15, 2003, which are herebyincorporated by reference in their entireties.

The zero-closure seal in the illustrated embodiment is shown in moredetail in FIG. 1F, and as shown the illustrated zero-closure seal is inthe form of a duckbill seal 24. The seal 24 is configured to form a sealin the working channel 4 when no instrument is disposed therethrough tothus prevent the leakage of insufflation gases delivered through thetrocar 2 to the body cavity. As shown, the duckbill seal 24 has agenerally circular flange 34 with a sidewall 36 extending distallytherefrom. The shape of the sidewall 36 can vary, but in the illustratedembodiment, the sidewall 36 includes opposed flaps 35 that extend at anangle toward one another in a distal direction and that come together ata distal end to form a seal face 38. The opposed flaps 35 are movablerelative to one another to allow the seal face 38 to move between aclosed position, in which no instrument is disposed therethrough and theseal face 38 seals the working channel 4 of the trocar 2, and an openposition in which an instrument is disposed therethrough. The seal caninclude various other features, as described in more detail in U.S.application Ser. No. 11/771,263, entitled “Duckbill Seal with FluidDrainage Feature,” filed on Jun. 29, 2007, which is hereby incorporatedby reference in its entirety.

In accordance with the present disclosure the general structure of theseals as well as the trocar do not generally form part of the presentinvention. As such, a person skilled in the art will certainlyappreciate that various seal configurations, as well as various trocars,can be used without departing from the spirit of the invention disclosedherein.

As indicated above, a fluid remover can be disposed within the trocar 2to remove fluid from a seal and/or from a surgical instrument extendingthrough the seal. As best shown in FIGS. 1B-1C, the illustrated trocar 2includes a fluid remover assembly 40 that is disposed within theproximal housing 6 of the trocar 2 at a location distal of the duckbillseal 24. The fluid removal assembly 40 includes a scraper for scrapingfluid off of a surgical instrument passed through the working channel 4in the trocar 2, and a sorbent for sorbing removed fluid. The scrapercan also include a wicking feature for wicking fluid away from theopening in the scraper, and/or the sorbent can include a wicking featurefor wicking fluid away from the scraper.

The components of the fluid remover assembly 40 are shown in more detailin FIGS. 1G-1K, and as shown the assembly generally includes a lid 42(FIG. 1K), a scraper 44 (FIG. 1G), a sorbent wick 46 (FIG. 1H), sorbentcartridges 48 (FIGS. 1I), and a housing or frame 50 (FIG. 1J). Whenfully assembled, the fluid remover assembly 40 is configured to scrapefluid off of surgical instruments passing through the working channel 4of the trocar 2, to wick the scraped fluids away, and to sorb them,thereby preventing the fluids from being redeposited on the instrumentupon reinsertion through the working channel.

Referring first to FIG. 1G, the scraper 44 can have a variety ofconfigurations, but in an exemplary embodiment, as shown, the scraperhas a generally planar configuration with a circular shape. A centralopening 52 is formed through a central portion thereof and is sized andconfigured to receive a surgical instrument therethrough. In use, thecentral opening 52 can be coaxial with openings in the instrument andchannel seals. The scraper 44 can be formed from various materials, butin an exemplary embodiment the scraper is formed from polyisoprene toallow the scraper 44 to engage and scrape fluid off of any instrumentpassed therethrough. As further shown in FIG. 1G, a distal-facingsurface 54 of the scraper 44 can include a plurality of channels 56formed therein and extending radially outward from the central opening52, or from a location just radially outward but adjacent to the centralopening 52. The channels 56 can be configured such that fluid scrapedoff of an instrument by the central opening 52 will flow into thechannels 56 and thereby be wicked away from the opening 52.

As indicated above, the fluid remover assembly 40 can also include asorbent wick 46. As shown in FIG. 1H, in an exemplary embodiment thesorbent wick 46 has a generally planar circular portion 62 with acentral opening 58 formed therethough. The central opening 58 can have adiameter slightly larger than a diameter of the central opening 52 inthe scraper 44, and it can be configured to be positioned coaxial withthe opening 52 in the scraper 44. As further shown in FIG. 1H, thesorbent wick 46 can also include one or more sidewalls 60 extending fromthe planar circular portion 62. The illustrated sidewalls 60 extendproximally, however they can extend distally depending on the particularconfiguration of the wick 46. The sidewalls 60 can be configured to sitwithin the inner sidewall 3 of the trocar housing 6. In use, the sorbentwick 46 can wick and sorb fluid away from the central opening 52 in thescraper 44, and it can deliver the fluid to the sorbent cartridges 48,as discussed in more detail below. The sorbent wick 46, as well asvarious other sorbent members disclosed herein, can be formed from avariety of sorbent materials as described above.

The sorbent cartridges 48 are shown in more detail in FIG. 1I, and asshown the cartridges 48 each have a generally semi-circular shape with awidth, as measured from an internal surface 64 to an external surface66, that decreases in a proximal to distal direction to formwedge-shaped members 68. Together, the cartridges 48 can have an annularconfiguration. In use, the cartridges 48 can sorb fluid from the sorbentwick 46, thereby storing the fluid at a location away from anyinstrument passed through the working channel 4. The cartridges 48 canbe contained within the trocar 2 by a housing or frame 50, as shown inFIG. 1J. The frame 50 can have a generally cylindrical configurationwith an opening 68 extending therethrough, and a plurality of ridges 70protruding radially outward and extending axially along an outer surface72 thereof. Each sorbent cartridge 48 can be seated between two ridges.In use, the frame 50 can be particularly advantageous as it can protectthe sorbent from being contacted by instruments passing through theworking channel.

When fully assembly, the scraper 44 can be seated within the sorbentwick 46, which can rest on top of the frame 50 that holds the sorbentcartridges 48. The lid 42, shown in FIG. 1K, can be seated on top of thescraper 44 and within the sorbent wick 46, and the lid 42 can lock ontothe frame 50, thereby holding the fluid remover assembly 40 together.Referring to FIG. 1C, the entire assembly 40 can be seated within theproximal housing 6 of the trocar 2 just distal of the duckbill seal 24.As a result, when an instrument, such as a scoping device, is passedthrough the working channel 4 of the trocar 2, any fluid on theinstrument will be scraped off of the sidewalls of the instrument by thescraper 44. The fluid will flow through the channels 56 and/or be wickedaway from the opening 52 by the sorbent wick 46, which delivers thefluid to the sorbent cartridges 48. As a result, when the instrument iswithdrawn, for example, the fluid will be prevented from being depositedonto the instrument seal 14, thereby preventing the fluid from beingtransferred from the instrument seal 14 back onto the instrument uponreinsertion.

FIGS. 2A-2B illustrate yet another embodiment of a fluid removerassembly 80 that is similar to the embodiment shown in FIG. 1A. In thisembodiment, the proximal housing 79 of the trocar has a frame 82 that ismolded into the inner sidewall 81 of the housing 79 for directly seatinga sorbent, a scraper, and a lid, thereby eliminating the need for theframe 50 of FIG. 1J. A single sorbent element 86 is also provided,rather than a sorbent wick and separate sorbent cartridges. Inparticular, the sorbent element 86 in this embodiment has a generallycylindrical configuration with a distal portion 88 that tapers inward onan outer surface 87 thereof to conform to the inner surface 81 of theproximal housing 79 of the trocar. A recess 90 can be formed around aninner surface 92 of a proximal end 93 of the sorbent element 86 to seata scraper 94, which can have a configuration that is the same as orsimilar to the scraper 44 described above with respect to FIG. 1G. Therecess 90 can engage an outer perimeter 96 of the scraper 94 such thatthe channels 56 on the scraper 94 can deliver fluid away from theopening 52 in the scraper 94 to the sorbent element 86 surrounding thescraper 94. A cap 98 can sit on top of the scraper 94 and can include aflange 99 that extends around the proximal end 93 of the sorbent element86. The cap 98 can engage the inner sidewall 81 of the proximal housing79 of the trocar to retain the scraper 94 and sorbent element 86 thereinat a location just distal of the duckbill seal 24. In use, instrumentspassed through the working channel 4 of the trocar will be engaged bythe scraper 94, which scrapes fluid off of the outer surface of theinstrument. The fluid is wicked away from the opening 52 in the scraper94 by the channels 56, which deliver the fluid to the sorbent element 86surrounding the scraper 94. Thus, similar to the embodiment of FIG. 1A,when the instrument is withdrawn, for example, the fluid will beprevented from being deposited onto the seals, and in particular theinstrument seal 14, thereby preventing the fluid from being transferredfrom the instrument seal 14 back onto the instrument upon reinsertion.

A person skilled in the art will appreciate that the fluid removerassemblies 40, 80 can have a variety of other configurations. FIGS.3A-10B illustrate additional exemplary embodiments of fluid removers,e.g., scrapers, sorbents, and wicking elements, or combinations thereof.In these embodiments, the fluid removers are all located distal of thechannel seal, e.g., duckbill seal or other zero-closure seal, and distalof the instrument seal 14. However a person skilled in the art willappreciate that the particular location of the fluid remover can varyand the fluid removers can be positioned anywhere within the trocar.

FIGS. 3A-3C illustrate one embodiment of a fluid remover assembly 100having a scraper and a sorbent. In particular, as best shown in FIG. 3B,the fluid remover assembly 100 can include a stabilization cup 106coupled to a flange 108. The stabilization cup 106 can be formed from asorbent material and the flange 108 can seat the cup 106 within theproximal housing 6 of the trocar 2, as shown in FIG. 3C. A scraperelement in the form of a scraper disc 102 can be positioned between theflange 108 and the stabilization cup 106, and a sorbent ring 104 can becoupled to a distal surface 103 of the scraper disc 102. The scraperdisc 102 can have a central opening 105 extending therethrough andconfigured for scraping fluid off of surgical instruments passed throughthe working channel 4 of the trocar 2. As an instrument is passedthrough the working channel 4, fluid can be scraped by the scraper disc102 and sorbed by the sorbent ring, as well as by the stabilization cup.As can be seen in FIG. 3B, the flange 108, scraper disc 102, and sorbentring 104 can each optionally include cut-outs 110 to fit around thestop-cock 13 associated with the trocar 2. In use, the fluid removerassembly 100 can be formed as a drop-in unit that fits within theproximal housing 6 of the trocar 2. As shown in FIG. 3C, the assembly100 can be seated in a distal portion of the proximal housing 6 at alocation just distal of the duckbill seal 24. The fluid remover assembly100 will thus remove fluid from instruments passed through the workingchannel 4 of the trocar, thereby preventing fluid from being depositedonto the seals, and in particular the instrument seal 14, and/orredeposited onto instruments passed through the working channel 4.

FIGS. 4A-4C illustrate another embodiment of a fluid remover assembly114 that is similar to the assembly shown in FIGS. 3A-3C, however inthis embodiment the assembly 114 does not include a stabilization cup.As shown, the fluid remover assembly includes a substantially planarcircular scraper disc 116 having a central opening 115 for receiving asurgical instrument. The scraper disc 116 can be seated within a flangeor retainer ring 118 configured to be positioned within the proximalhousing of a trocar. A sorbent ring 120 can be positioned adjacent to adistal surface 117 of the scraper disc 116 and it can act to sorb anyfluid that is scraped off of instruments passed through the scraper disc116. When disposed within a trocar, the flange 118 can act as a supportstructure to hold the scraper disc 116 and the sorbent ring 120 in afixed position within the proximal housing. While the position can bedistal to the duckbill seal, as indicated above the assembly can belocated at various other portions within the trocar, including betweenthe duckbill seal and the instrument seal, proximal to the instrumentseal, or within any portion of the cannula.

In another embodiment, shown in FIGS. 5A-5C, a fluid remover assembly122 is provided and can have a generally conical configuration with ascraper 124 having a proximal generally planar flange 125 and a conicalbody 126 extending distally therefrom and defining a central opening128. The conical body 126 can have a plurality of slits 127 extendingproximally from a distal end thereof and designed to reduce insertionand withdrawal forces on a surgical instrument passed therethrough. Theconical body 126 can be surrounded by a conical sorbent element 130 suchthat the conical body 126 is nested within the conical sorbent element130. When assembled and disposed within a trocar, as shown in FIG. 5C,the flange 125 can be seated within the proximal housing 6 just belowthe duckbill seal 24 and it can mate to or engage the inner sidewall ofthe housing 6 to retain the fluid remover assembly therein. In use, asan instrument is passed through the working channel, the scraper 124 canengage and scrap fluid off of the instrument and the sorbent element 130can sorb the fluid. A person skilled in the art will appreciate that anynumber of geometries can be used in a similar way. Also, a size ordiameter of a flange can be adjusted as needed, or the flange can beremoved, to seat the fluid remover assembly at other locations withinthe trocar.

FIGS. 6A-6C illustrate additional embodiments of conical scrapers 132 a,132 b, 132 c that are similar to the scraper 124 described above andshown in FIGS. 5A-5C. As with the previous embodiment, the scrapers 132a, 132 b, 132 c in FIGS. 6A-6C are positioned distal to the duckbillseal 24. Such a configuration can prevent fluid on instruments beinginserted and/or withdrawn from being deposited onto the duckbill seal,as well as the more-proximally located instrument seal 14. In anexemplary embodiment, each scraper 132 a, 132 b, 132 c can be made froma pliable material and can include at least one slit formed therein andconfigured to allow the scrapers 132 a, 132 b, 132 c to radially expand.A variety of configurations are available for the slit(s). In theembodiment shown in FIG. 6A, a single slit 134 extends diagonally aroundthe scraper 132 a such that the slit 134 follows the shape of the cone.In another embodiment shown in FIG. 6B, multiple slits 137 extendproximally from the distal end of the cone and terminate at a location139 just distal to the proximal end. Such a configuration can yield ascraper having multiple scraping segments 138. As further shown in FIG.6B, each scraping segment 138 can also include a notch or cut-out 140formed in an outer surface at the distal end thereof to allow thesegment 138 to expand and contact as instruments are passedtherethrough. FIG. 6C illustrates another exemplary embodiment of a coneshaped scraper 132 c. Similar to the scraper 132 b shown in FIG. 6B, thescraper 132 c includes several slits 142 that extend proximally from thedistal end thereof. In this embodiment, however, the slits 142 increasein width in a distal to proximal direction such that each scrapingsegment 143 has a distal end 144 with a width that is greater than awidth of a proximal end 145 thereof. As indicated above, in use theslit(s) 134, 137, 142 formed in the scrapers 132 a, 132 b, 132 c allowthe scrapers to radially expand as a surgical instrument is passedtherethrough, thus accommodating instruments of various sizes whilestill being effective to scrape fluid off of the instruments.

FIG. 7 illustrates another embodiment of a fluid remover positioned justdistal of a channel seal, e.g., duckbill seal 150, in a proximal housingof a trocar. In this embodiment, the fluid remover is in the form ofsorbent flapper doors 152. The flapper doors 152 can have various shapesand sizes, and they can be formed from any number of components. Forexample, the flapper doors 152 can be in the form of two sidewalls 153that are movable relative to one another. The sidewalls 153 can have aprofile that is similar to the profile of the duckbill seal 150. Inother embodiments, the flapper doors 152 can have a shape thatcorresponds to the shape of the duckbill seal 150. A person skilled inthe art will appreciate that various configurations are possible. Theflapper doors 152 can be seated inside the proximal housing 6 andattached to the housing 6 by any attachment means known in the art,including by mechanical means, adhesives, etc. The flapper doors 152 candefine an opening 154 therebetween for receiving a surgical instrument,and the opening 154 can be positioned just distal of the seal face 151.In use, the flapper doors 152 can move from a closed or substantiallyclosed position to an open position as an instrument is passed throughthe duckbill seal 150 and the flappers door 152. The doors 152 cancontact and engage the surgical instrument as it is being passedtherethrough to sorb fluids off of the instrument. The flapper doors 152can also sorb any excess fluid that is scraped off of the instrument bythe duckbill seal 150 and that falls distally from the duckbill seal150.

In a similar embodiment, shown in FIG. 8, the fluid remover can be inthe form of a wicking element rather than a sorbent. In the illustratedembodiment, the wicking element is in the form of first and secondwicking fingers 160 a, 160 b that are coupled to opposed outer edges 162of the seal face 161 on the duckbill seal 163. The wicking fingers 160a, 160 b can be in the form of elongate members that follow the naturalshape of the inner sidewall 165 of the proximal housing 6 of the trocar2 so that fluid will run naturally down the fingers 160 a, 160 b. Thewicking fingers 160 a, 160 b can also include a sorbent reservoir 164disposed on a distal end thereof. In the illustrated embodiment, thesorbent reservoir 164 on each finger 160 a, 160 b is in the shape ofring seated within the proximal housing 6 and effective to sorb thefluids wicked away from the duckbill seal 163 by the wicking fingers 160a, 160 b. The sorbent reservoir 164 can, however, have various otherconfigurations such as ring segments. In use, as fluids are deposited onthe duckbill seal 163 by instruments passing therethrough, the fluidwill naturally flow to outer corners or edges of the seal face 161. Thesurface difference between the wicking fingers 160 a, 160 b and theduckbill seal 24 will cause fluid to flow from the seal 163 to thefingers 160 a, 160 b and down the fingers 160 a, 160 b into the sorbentreservoir 164. As will be appreciated by those skilled in the art, thewicking fingers 160 a, 160 b can be formed integrally with the duckbillseal 163 or can simply be in close contact with sealing face 161 of theduckbill seal 163.

FIG. 9 illustrates another embodiment of a fluid remover that ispositioned distal of a zero-closure seal. Similar to the embodimentshown in FIG. 7, the fluid remover is in the form of a sorbent. However,in this embodiment the sorbent is a sorbent grommet 172. The grommet 172can have a generally circular or conical configuration with an opening173 formed therethrough, as shown, but it can have any number of othergeometries to facilitate passage of an instrument therethrough. Thegrommet 172 can also include multiple slits 174 formed therein andextending radially outward from the opening 173 to reduce insertion andwithdrawal forces on an instrument being passed therethrough. In use,the grommet 172 can be seated within a distal portion of the proximalhousing 6 of the trocar, just distal of the duckbill seal 166, and theopening 173 can be positioned coaxial with the working channel 4. As asurgical instrument is passed therethrough, the grommet 172 will contactthe instrument and sorb any fluid on the instrument. The grommet 172 canalso sorb any fluid that drips off of the duckbill seal 166 as the seal166 scrapes the instrument.

In other embodiments, the zero-closure seal itself can be modified toinclude a fluid remover. For example, FIGS. 10A and 10B illustrateanother embodiment of a duckbill seal 176 in which the seal face 168 isextended distally and expanded in width to cause the outer ends of theseal face 168 to contact the inner sidewall 169 of the proximal housing6 of the trocar, thereby forming a wicking element. In use, when aninstrument is passed through the duckbill seal 176, the seal face 168will scrape fluid off of the instrument. The fluid will naturally runoutward toward the outer-most edges of the seal face 168. Since theouter edges are in contact with the inner sidewall 169 of the proximalhousing 6, the fluid will be wicked away from the seal face 168 and ontothe inner sidewall 169 of the housing 6. While not shown, the housing 6can optionally include a sorbent disposed therein for sorbing the fluidwicked away from the seal.

FIG. 11 illustrates another embodiment of a modified zero-closure seal186. In this embodiment, a sorbent element 180 is nested inside of theduckbill seal 177, and a second duckbill seal 178 is nested within thesorbent element 180. The nested sorbent 180 and the nested duckbill seal178 can have two sealing walls, 182, 184 similar to the duckbill seal177, that meet at a seal face that is configured to form a seal when noinstrument is disposed therein and that are configured to open when asurgical instrument is passed therethrough. The body of the nestedsorbent 180 and the nested duckbill 178 can each have a profile similaror identical to the duckbill seal 177, except smaller in size to all fitfor a nested configuration. The components 177, 178, 180 can merely beseated within one another, or they can be attached to one another usingvarious attachment mechanisms known in the art, including a press fit,glue, etc. In use, the seal face of all three components will contact asurgical instrument as it is passed through the seal assembly. Thesorbent 180 will thus sorb any fluid on the instrument, as well as fluidscraped off of the instrument by the duckbill seal 177 and the nestedduckbill seal 178.

FIGS. 12A-12B illustrate another embodiment of a modified zero-closureseal 190. In this embodiment, the duckbill seal 191 includes two sorbentbars 192 disposed therein and extending thereacross. The sorbent bars192 can be positioned to extend substantially parallel to the seal face193, or to extend substantially perpendicular as shown. The seal 190 canalso include a sorbent ring 194 positioned around an inner sidewall 193of the duckbill seal 191 and in contact with the sorbent bars 192. Thesorbent ring 194 can provide a reservoir for fluid collected by thesorbent bars 192. In use, the sorbent bars 192 will contact and engage asurgical instrument as it is passed through the duckbill seal 191, andwill thus sorb fluid away from the surgical instrument.

As indicated above, the various fluid remover embodiments disclosedherein can be located anywhere within a trocar or other access device,including distal of a channel seal, between a channel seal and aninstrument seal, or proximal of an instrument seal. The position of thefluid remover can also vary relative to an insufflation port, as will bediscussed in more detail below. The fluid removers can also be formedintegrally with the seal(s) and/or portions of the housing, and anycombination of fluid removers can be used. FIGS. 13-22B illustratevarious exemplary embodiments of fluid removers that are formedintegrally or incorporated into an instrument seal, or located adjacentto an instrument seal and thus proximal to a channel seal.

Turning first to FIG. 13, in this embodiment the fluid remover 200 is inthe form of a combination scraper and sorbent. In particular, the fluidremover 200 includes a generally planar circular scraper disc 202 havingan opening 204 formed therethrough and configuration to be positionedcoaxial with the working channel 4 in the trocar 2. The opening 204 canbe sized and configured to form a seal around an instrument passedtherethrough. The fluid remover 200 can also include a sorbent disk 206disposed concentrically around the opening 204 in the scraper 202. Inuse, the scraper 202 will scrape fluid off of instruments passedtherethrough, and the sorbent disk 206 will sorb the scraped fluid. Thefluid remover 200 can be disposed within the proximal housing 6 of thetrocar 2 using various techniques, but as shown in FIG. 13 the fluidremover 200 is configured to be engaged between the removable cap 5 andthe distal portion of the proximal housing 6 of the trocar 2. As aresult, the scraper 202 and sorbent 206 will be positioned in alignmentwith the working channel 4 extending through the housing 6, and willalso be positioned between the proximal instrument seal and the distalchannel seal.

FIG. 14 illustrates another embodiment of a fluid remover 210 having acombination scraper and sorbent, however in this embodiment the fluidremover 210 is fully disposed within the removable cap 5 containing theinstrument seal. As shown, a scraper 212 can be cone shaped and can bepositioned just distal of the instrument seal. In other embodiments thescraper 212 can be planar. The scraper 212 can also replace or functionas the instrument seal. A sorbent ring 214 can be positionedconcentrically around and in contact with an opening 216 in the distalend of the of the conical scraper 212. As a result, the sorbent ring 214will sorb any fluid scraped away from a surgical instrument extendingthrough the scraper 212.

In yet another embodiment, shown in FIGS. 15A and 15B, the fluid removercan be in the form of a scraper that is part of the instrument seal 218.As shown, the instrument seal 218 is a multi-layer seal having theprotector disposed on a proximal surface thereof, as previouslydescribed with respect to FIG. 1E. The scraper can be in the form of asecond protector 222 that is disposed distal to the multi-layer sealsegments. The second protector 222 can have the same configuration asthe protector of FIG. 1E, however the second protector 222 can define anopening 224 that is configured to contact and engage a surgicalinstrument passed through the seal 218. Accordingly, in use, the secondprotector 222 can engage and scrape fluid away from instruments passedthrough the seal 218.

In another embodiment, shown in FIG. 16, the fluid remover can be in theform of a multi-layer sorbent that is positioned between the multiplelayers 20 of the seal 16, as shown, or that is positioned between themultiple layers 22 of the seal protector 18. The sorbent can be in theform of multiple sorbent sheets 232 that are layered in between thelayers of the seal 16 (or seal protector 18). Thus, in use, when aninstrument is passed through the instrument seal, the sheets 232 willsorb any fluids scraped off of the instrument by the seal 14, therebypreventing fluid from accumulating around the opening of the seal 14 andbeing reapplied to a surgical instrument as it is reinsertedtherethrough. The sorbent sheets 232 can be effective to sorb fluid, aswell as to interrupt surface tension and/or capillary action between theseal and the protector. Thus, there should be no fluid in or near theseal opening and/or protector opening that will be able to touch orcollect on an instrument being passed therethrough.

FIG. 17 illustrates another embodiment of a sorbent fluid remover. Inthis embodiment, the sorbent is in the form of a grommet 242 having aconfiguration similar to the grommet 172 previously described withrespect to FIG. 9. However, in this embodiment the grommet 242 ispositioned adjacent to a distal surface 244 of the instrument seal 14,rather than the zero-closure seal 24. In particular, as shown in FIG.17, the grommet 242 can be disposed concentrically around a distalopening 246 formed in the removable cap 5 such that instruments passedthrough the instrument seal 14 will contact the grommet 242, which willsorb fluids off of the instrument. The grommet 242 can also sorb anyfluid that is scraped from or drips from the instrument seal 14.

In another embodiment shown in FIGS. 18A and 18B, a wicking element isformed integrally with the multi-layer seal protector 18 previouslydescribed with respect to FIG. 1E. As previously explained, themulti-layer seal 16 can have a natural shape that is slightly conicaland it can include an opening sized to receive an instrumenttherethrough. The protector 18 likewise has an opening, however in theembodiment shown in FIGS. 18A and 18B the length of a protector 240 isdecreased to thereby increase the diameter of the opening defined by theprotector 18. As a result, the protector 240 will have an opening thatis larger than the opening in the seal 16 to create a flattened profileagainst the conical shape of the seal 16, thereby creating a gap betweenthe protector 240 and seal 16. As surgical instruments are removed fromthe trocar, the gap will prevent fluids from collecting between thelayers 20 of the seal 16 and will allow the protector 240 to wick fluidsaway from the opening of the seal 16. Thus, if fluid is deposited on theseal 16, there will be no capillary action to hold the fluid between theseal 16 and the protector 240, thereby allowing the fluids to drain. Inaddition, when an instrument is passed through the protector 240 andseal 16, the gap created between the seal 16 and protector 18 willprevent fluid from being squeezed from between the seal 16 and protector240 and onto an instrument.

In another embodiment shown in FIGS. 19A and 19B, the multi-layer sealprotector 248 has a wicking element in the form of camming ribs 250disposed on a surface of each individual protector layer 249 so that theribs 250 create pockets between the layers for wicking away andretaining fluid scraped off of instruments by the instrument seal. Inthe illustrated embodiment, the ribs 250 are offset by 90 degrees,although other geometries are possible as will be appreciated by thoseskilled in the art. In one embodiment, the ribs 250 can be disposed on atop or proximal surface of the protector. Thus, as a surgical instrumentis passed through the instrument seal 14, the instrument will contactthe ribs 250 to thereby cam open the protector 248 and the seal,preventing the surgical instrument from coming into contact with thesurface of the protector 248 and/or the seal. In another embodiment, theribs 250 can be disposed on a bottom or distal surface of the protector,thereby creating a gap between the protector 248 and the seal to preventcapillary action and the trapping of fluid between the seal andprotector 248.

FIGS. 20A and 20B illustrate another embodiment of an instrument seal254 having ribs for wicking fluid away from an opening in the seal 254.In this embodiment, the instrument seal 254 is in the form of a deepcone seal having a flange 260 with a conical sidewall 262 extendingdistally therefrom. A distal portion 264 of the conical sidewall 262tapers inward to define an opening 258 in the distal end 264 of the seal254. In the embodiment shown in FIG. 20A, the sidewall 262 can includeone or more ribs 266 formed on an external surface 261 thereof andextending between proximal and distal ends of the sidewall 262,terminating at the opening 258. The external ribs 266 can be effectiveto wick fluid away from the opening 258 in the seal 254. In theembodiment shown in FIG. 20B, the ribs 266 are formed on the innersurface 268 of the sidewall 262 and extend between proximal and distalends of the sidewall 262, terminating at the opening 258. The ribs 266will thus have a camming effect, causing any instrument inserted throughthe seal 254 to contact the ribs 266 to cam open the seal 254, ratherthan contacting an inner surface 268 of the seal 254.

In another embodiment, shown in FIG. 21, the multi-layer seal protector269 can include a plurality of holes 270 formed in the individual layers271 of the protector 269 to form a wicking element for wicking fluidaway from the seal. As fluid is trapped between the protector 269 andthe seal when an instrument is passed through the instrument seal, theholes 270 act to wick away fluid from the seal and from the opening inthe seal. The fluid can be retained within the holes 270 by surfacetension so that an instrument passed through the seal will not contactthe fluid retained in the holes 270.

Various other modifications can also be made to the multi-layer sealprotector previously described in FIG. 1E to remove fluid from the sealor from instruments passed through the seal. In another embodiment,shown in FIGS. 22A and 22B, the protector segments 272 can includesurface features, such as a roughened surface 276, formed on the distalsurface thereof. As shown in FIG. 22B, when the protector segments 272are positioned against the seal segments 20, the roughened surface 276will create a gap that separates the protector 273 from the seal, thusproviding a path for fluid to wick away from the opening in the seal andfrom between the protector 273 and the seal.

FIGS. 23A-23B illustrate another embodiment of a seal 280 that isconfigured to remove fluid. In this embodiment, the seal 280 has anhourglass configuration such that the seal 280 is a combination trocarand instrument seal. In other words, the seal 280 is effective to bothform a seal within the working channel of the trocar when no instrumentis disposed therethrough and to form a seal around an instrumentdisposed therethrough. The hourglass shape of the seal 280 allows acentral portion 282 of the seal 280, which in a natural state is in aclosed configuration as shown in FIG. 23A, to open and engage aninstrument passed therethrough, as shown in FIG. 23B, and thereby scrapeany fluid off of the instrument. Due to the curvature in inner sidewalls284 of the seal 280, the removed fluid will flow away from the centralportion thus preventing the fluid from being redeposited onto aninstrument reinserted therethrough. The hourglass configuration of theseal 280 is also advantageous in that it will accommodate instruments ofvarious sizes. The central portion 282 can also move or float relativeto the central axis of the working channel in the trocar, thusaccommodating off-axis instruments.

FIGS. 24A-29 illustrate various other exemplary embodiments of fluidremovers. While certain embodiments are described as being disposed orformed in the cannula, a person skilled in the art will appreciate that,as with previous embodiments, the embodiments of FIGS. 24A-29 canlikewise be disposed at various locations within a trocar and thatvarious combinations of fluid removers can be used.

In the embodiment shown in FIGS. 24A and 24B, the fluid remover is inthe form of a plurality of scraper elements that extend at leastpartially across the working channel 4 of the cannula 8. The scraperelements can be relatively thin and can take the shape and form ofwipers 292, as best shown in FIG. 24B, that will scrape or squeegeefluid off of a surgical instrument passed through the cannula 8. Thewipers 292 can be fixedly or hingedly coupled to an inner sidewall 294of the cannula 8, and they can be flexible to accommodate instruments ofvarious sizes, and to allow both insertion and withdrawal of theinstruments. The cannula 8 can also include any number of wipers 292,and the wipers 292 can be spaced apart from one another, or they can bein a stacked configuration. The wipers 292 can have a conicalconfiguration such that each wiper 292 extends around the entire innerdiameter of the cannula 8. Alternatively, the wipers 292 can be formedinto individual segments that are positioned a distance apart from oneanother, e.g., approximately 90 degrees apart within the interiorsurface 294 of the cannula 8. The segments can be layered within thecannula 8 so that different parts of the surgical instrument come intocontact with the wipers 292 at different heights as the instrument isbeing passed therethrough. The wipers 292 can also be in contact with asorbent element 296, or include a sorbent portion, such that thecollected fluid drips onto or is wicked into the sorbent material andaway from possible contact with a reinserted instrument. As shown inFIGS. 24A-24B, the sorbent element 296 is located adjacent to the innersidewall 294, and thus radially outward from the wiper body 292. Thesorbent elements 296 can be formed into a wall of the cannula 8, so thatthe cannula 8 is partially formed from the sorbent elements 296. Thesorbent elements 296 can also be formed within grooves in the cannulawall and/or can be adhered directly to the cannula wall by anyattachment mechanism known in the art, for example an attachment ring297. In use, as an instrument is passed through the cannula 8, theinstrument will be scraped on all sides simultaneously by the pluralityof wipers 292. The fluid will flow outward where it will be sorbed bythe sorbent element 296.

FIG. 25 illustrates another exemplary embodiment of a scraper 300. Inthis embodiment, the scraper 300 is substantially cone shaped increasingin diameter in a distal direction. A proximal end 302 of the scraper 300includes an opening 304 formed therethrough, and a fluid collectionmember is formed at a distal end 306 thereof and extends inwardly. Thefluid collection member can have a variety of configurations and can begenerally configured to collect fluid scraped by the scraper 300. In oneexemplary embodiment, as shown, the fluid collection member can be inthe form of a substantially C-shaped lip 308 extending inwardly from thedistal end 306 of the scraper 300. At least a portion of the fluidcollection member can also optionally be sorbent thereby enabling thefluid collection member to both collect and sorb fluid scraped by thescraper. The scraper 300 can be formed from a pliable material such thatit can radially expand to engage a surgical instrument extendingtherethrough. In use, the narrow proximal end of the scraper 300 canengage a surgical instrument passed therethrough to thereby scrape fluidaway from the instrument. The fluid scraped away from the instrumentwill run down an inner surface 310 of the scraper 300 and be collectedand/or sorbed by the fluid collection member disposed at the distal end306 of the scraper 300. While the scraper 300 is generally indicated asbeing disposed in the cannula 8, the scraper 300 can likewise bedisposed anywhere within the trocar 2, including in the proximal housing6.

FIG. 26 illustrates another exemplary embodiment of a scraper 312. Inthis embodiment, the scraper 312 includes first and second rotatablemembers 314 a, 314 b that are configured to rotate and engage a surgicalinstrument as the instrument is passed therethrough. The first andsecond rotatable members 314 a, 314 b can have a variety of shapes andsizes. In the illustrated embodiment, the first and second rotatablemembers 314 a, 314 b are spool shaped. The spools can be configured suchthat the geometry of second member 314 b complements that of the firstmember 314 a. As shown, the first member 314 a includes a substantiallyspherically shaped central portion 316 that corresponds with a concavecut-out 318 in the second member 314 b. The geometry of the spools canhave several shapes including, but not limited to, straight sidedcylindrical, c-shaped, and indented cylindrical. The first and secondrotatable members 314 a, 314 b can be positioned at a variety oflocations in the cannula, or within the proximal housing of a trocar,and they can be formed from a variety of materials including, but notlimited to, rigid, pliable, and sorbent materials. In use, the rotatablemembers 314 a, 314 b can rotate and engage a surgical instrument passedtherethrough to thereby scrape and optionally sorb fluid away from theinstrument.

FIGS. 27A-27C illustrate another embodiment of a fluid remover in theform of a removable tip or sleeve 322 that can be removable coupled to adistal end 324 of the cannula 8. As shown, the sleeve 322 is in the formof a generally cylindrical housing with a tapered distal end 326,similar to the distal end 324 of the cannula 8. A proximal end 328 ofthe sleeve 322 can be sized to fit over and engage the distal end of thecannula 8, e.g., by interference fit, and the distal end of the housingcan include an opening 330 formed therein and sized to receive asurgical instrument therethrough. The sleeve 322, or at least a portionof the sleeve 322 surrounding the opening 330 at the distal end 326, canbe formed from a compliant or expandable material to allow the openingin the sleeve 322 to radially expand as an instrument is passedtherethrough. Exemplary compliant materials include, but are not limitedto, polyisoprene, pellathane, and silicone. In use, as a surgicalinstrument is passed through the opening 330 in the sleeve 322, theopening 330 will scrape fluid off of the instrument, thereby preventingthe fluid from being dragged into the trocar and deposited on the seals.

In another embodiment shown in FIG. 28, an hourglass shaped seal 340,similar to the seal 280 described with respect to FIGS. 23A-23B isprovided, however the seal 340 includes a wicking element in the form ofone or more cut-outs or slots 342 formed in the central,reduced-diameter portion 344. Similar to the seal 280 previouslydescribed with respect to FIG. 23A and 23B, the hourglass shape willallow the central portion 344 to scrape or squeegee fluid from asurgical instrument passed therethrough. The cut-outs or slots 342 willallow the scraped fluid to be wicked through the slots 342 to anexterior surface 346 of the seal 340.

In another embodiment shown in FIG. 29, the wicking element can take theform of a plurality of slots 350 formed in the working channel 4 of acannula 352. The slots 350 can have any size and shape sufficient totransfer fluid disposed on an inner surface of the cannula 352 to anoutside surface 354 of the cannula 352. Thus, as an instrument is passedthrough the cannula 352, any fluid that drips down the inner surface ofthe cannula 352 will be transferred to the external surface 354 of thecannula 352 through the slots 350.

FIGS. 30A-30J illustrate another embodiment of a trocar 400 having afluid remover 430 disposed therein. As shown, the trocar 400 has aproximal housing 402 and a distal cannula 404 with a working channel 408formed through and extending between proximal and distal ends 400 a, 400b thereof. The housing 402 can include one or more seals that areeffective to seal the working channel 408, i.e., to prevent the escapeof insufflation, when no instrument is disposed therethrough and/or whenan instrument is disposed therethrough. As shown in FIGS. 30B and 30C,the housing 402 includes a proximal instrument seal, in the form of amulti-layer seal 412, that is effective to form a seal around aninstrument inserted therethrough, and a distal channel seal, such as aduckbill seal 410, that is effective to seal the working channel when noinstrument is inserted therethrough. One exemplary embodiment of aduckbill seal 410 that can be used with the present invention isdisclosed in U.S. patent application Ser. No. 11/771,263 filed on Jun.29, 2007 and entitled “Duckbill Seal With Fluid Drainage Feature,” byPaul T. Franer and Thomas A. Gilker. Such a duckbill is particularlyuseful as it has a low profile and has fluid drainage features that canassist in further preventing fluid from being redeposited ontoinstruments inserted through the seals. A person skilled in the art willappreciate that any number, type, and configuration of channel and/orinstrument seals can be positioned within the housing 402 at variouslocations. The housing can also include an insufflation port 406 isformed in the housing 402 for providing an insufflation gas to theworking channel 408. Additionally, in some implementations, the distalcannula 404 can include an angled distal surface arranged at distal end400 b. The angled distal surface can have a distal-most point and aproximal-most point, and the distal-most point can be aligned with theinsufflation port 406, as depicted in FIG. 30A.

As indicated above, the housing 402 can include a fluid remover 430positioned therein and configured to remove fluid from a surgicalinstrument inserted therethrough. The fluid remover 430 can have anopening 470 formed through a center portion thereof, in axial alignmentwith the working channel 408, for receiving a surgical instrument. Theopening 470 can be effective to remove fluid from a surgical instrumentupon insertion and/or withdrawal therethrough. In an exemplaryembodiment, the fluid remover 430 is preferably positioned distal to theseals 412, 410 so that fluid collected on the instrument when disposedin a body cavity can be removed from the surgical instrument before itis withdrawn through the seals 412, 410, thus preventing the fluid frombeing deposited on the seals and thereafter deposited onto an instrumentinserted into the trocar. In order to position the fluid remover 430distal to the seals 412, 410, the fluid remover 430 will positionedproximal to, distal to, or in the path of the insufflation port. Wherethe fluid remover 430 is positioned in the path of or distal to theinsufflation port, it is preferably configured so that it does not blockthe path of an insufflation gas from the port through the distal cannula404. During many surgical procedures using a trocar, insufflation isused to expand the body cavity into which the trocar extends. Trocarscan thus have an insufflation port, such as the port 406 shown in FIGS.30A-30C, that is positioned distal to the seals 412, 410 so that theseals are effective to prevent gas from flowing out of the proximalhousing 402. In this way, a constant flow of gas is maintained throughthe distal cannula 404 and into the body cavity. Since the port 406 ispositioned distal to the seals 412, 410, in an exemplary embodiment, inorder to maintain a low profile housing and position the fluid remover430 distal of the seals, the fluid remover 430 can be positionedadjacent to or distal to the port 406. As such, the fluid remover 430 ispreferably configured to allow air to pass therethrough and/ortherearound such that it does not block the flow of insufflation gasfrom the port 406 to the cannula 404 when an instrument is insertedthrough the opening 470 in the fluid remover 430. In other words, thefluid remover 430 can have a configuration that allows the passage ofinsufflation gas from the port 406 to the distal cannula 404 even whenan instrument is disposed through the fluid remover 430. FIGS. 30A-30Jillustrate one such embodiment of the fluid remover 430 that is in thepathway of the flow of gas from the port 406 to the cannula 404. In thisembodiment, a cut-out or pathway is provided in a portion of the fluidremover 430 to allow the passage of gas therethrough from the port 406to the cannula 404, as will be discussed in more detail below. The fluidremover 430 can also include other features to facilitate the passage ofgas therethrough, as will be discussed in more detail below.

The fluid remover 430 can have various configurations and it can includeany one or more of a wicking element, a sorbent, and a scraper. FIGS.30C-30F illustrate one embodiment of the fluid remover 430 that ispositioned distal to the seals 412, 410 and in proximity to theinsufflation port 406. The fluid remover 430 generally includes asorbent 414 disposed within the housing and disposed around a crown 420,a scraper 422 positioned on a proximal surface of the crown 420, and alid 418 positioned against a proximal surface of the scraper 422.

As shown in more detail in FIGS. 30F and 30G, the scraper 422 of thefluid remover 430 can have many shapes and configurations, but in theillustrated embodiment the scraper 422 is disc shaped and has an opening424 formed through a center portion thereof. The scraper 422 can beconfigured to remove fluid from a surgical instrument passing throughthe opening 424 by contacting the surgical instrument and scrapingand/or squeegeeing its circumference. In an exemplary embodiment, thescraper 422 is formed from a flexible and resilient material to allowthe opening 424 of the scraper 422 to expand around and engage an outerwall of an instrument passed therethrough.

The scraper 422 can also include features to direct fluid flow. Forexample, as shown in FIG. 30G, the scraper can include one or morechannels 422 c formed in a distal surface thereof and extending radiallyoutward from the opening 424 such that fluid scraped off of aninstrument being withdrawn through the opening 424 will flow through thechannels and radially away from the opening 424. As further shown inFIGS. 30F and 30G, the scraper 422 can also include one or more holes422 h formed therethrough for receiving pins formed on the crown 420, aswill be discussed in more detail below. The holes 422 h allow thescraper 422 to rest on a proximal surface of the crown 420 and to becaptured between the crown 420 and the lid 418. The holes 422 h can alsohave a size that allows air to pass therethrough when the pins of thecrown 420 are disposed therein. Such a configuration can assist inpreventing the fluid remover 430 from functioning as a seal, as will bediscussed in more detail below. In some embodiments, however, thescraper 422 can also be formed as an instrument seal and/or as a scraperfor smaller diameter surgical instruments and a seal for larger diametersurgical instruments.

In certain exemplary embodiments, in order for the scraper 422 toeffectively wick fluid radially outward from the opening and toward thesorbent, all or portions of the scraper can be formed from or caninclude a hydrophilic material. For example, the scraper can be formedfrom a hydrophilic material, such as a nylon, and/or the scraper can bespray coated, dip-coated, plasma etched, or otherwise coated usingvarious known coating techniques, with a surfactant coating that rendersthe scraper or portions thereof hydrophilic. In an exemplary embodiment,where the scraper is formed from a hydrophobic material, such as apolyisoprene, a hydrophilic coating is applied to the scraper to renderthe scraper hydrophilic. The coating can be applied to any one or moreof the surfaces of the scraper, and it can be applied at any stageduring manufacturing. In one embodiment, the scraper can be soaked in asurfactant bath during manufacturing to render the entire scraperhydrophilic. Exemplary coating materials include, by way of non-limitingexample, Dodecylbenzene sodium sulfonate (SDBS), and Sodium DodecylSulfate (SDS). The coating is preferably one that remains stable duringsterilization, such as gamma and thermal sterilization.

A person skilled in the art will appreciate that various factors can bealtered to facilitate the wicking action of the scraper. For example,the contact angle of a drop of fluid on a hydrophilic surface of thescraper can be optimized so that fluid will spread upon contact with thesurface. In certain exemplary embodiments, the hydrophilic material canhave a low contact angle, such as 90 degrees or less. Other factors thatcan affect the ability of the scraper to wick fluid away from theopening include the smoothness of the surface, the geometry of thewicking channels, and the surface tension of the fluid being applied.For example, the channel geometry can be designed so as to provide thecapillary forces necessary to drive fluid to a minimum capillary heightso that the fluid will extend just past the outer wall of the crown 420to reach the sorbent 414. The channel geometry can be altered to achievethe desired capillary height. FIG. 30H illustrates one exemplaryembodiment of a channel geometry that is optimized to facilitate thecapillary action of the channel. As shown, the channel has a generallyU-shaped cross-sectional shape, with the inner corners, located at thebase of the channel, being rounded and having a radius of curvature r₁,and the outer corners, located at the opening of the channel, beingrounded and have a radius of curvature r₂. The channel can also have awidth w at the base, as measured between the opposed sidewalls of thechannel, that differs from a width w1 at the opening, as measuredbetween the outer rounded corners, and that also differs from a maximumwidth w₂ as measured from the outer-most ends of the channel at theopening. The difference between width w and width w₁ is indicated byreference x. The channel can further have a maximum height h, asmeasured from the base to the outer-most ends of the channel at theopening, that differs from a height h₁, as measured from the base to theouter rounded corners. The particular dimensions of the channel canvary. For example, the radius of curvature r₁ at the base of the channelcan be less than the radius of curvature r₂ at the opening of thechannel, and the width w at the base of the channel is less than thewidth w1 at the opening, which in turn is less than the maximum width w₂such that the width of the channel gradually increases from the base tothe opening. In an exemplary embodiment, however, the width w at thebase of the channel is preferably equal to or greater than the width w1at the opening. The dimensions and cross-sectional shape of the channelcan also vary along the entire length of the channel. For example, thechannel can have a height and/or width that increases or decreaseradially outward, such that the height and/or width of the channel nearthe central opening in the scraper is either less than or greater thanthe height and width of the channel near the outer perimeter of thescraper. Each channel can also reach a maximum height and/or width at acertain distance from the central opening, and the height and/or widthcan then remain constant along the remainder of the channel extendingradially outward from that location. A person skilled in the art willappreciate that the channel can be modified to obtain a desiredcapillary height so as to cause fluid to be driven from the scraperopening, past the crown, and to the sorbent.

As indicated above, other modifications can be made to achieve anoptimum wicking effect. In another embodiment, the scraper and sorbentcan both be configured to have a surface energy gradient, such that thesurface energy increases as fluid travels from the opening in thescraper, along the channels, and into the sorbent.

The fluid remover 430 can also include a scraper crown 420, shown mostclearly in FIG. 30F, that can extend distally from a distal surface ofthe scraper 422 and that can assist in mounting the scraper 422 andsorbent 414 within the housing. The scraper crown 420 can have variousconfigurations, but in the illustrated embodiment it has a ring shapedbody 434 with multiple pins 436 extending proximally therefrom. The pins436 can extend through the corresponding holes 422 h formed in thescraper 422 and into holes 418h formed in the lid 418, as shown in FIG.30J. The crown 420 and lid 418 can be mated to one another using varioustechniques, such as a pressed fit or interference fit, adhesive orwelding, etc. By engaging the scraper 422 between the lid 418 and thecrown 420, the scraper 422 can have an outer diameter that is less thanan inner diameter of the housing 402 such that a gap G is providedbetween the scraper 422 and the housing 402, as shown in FIG. 30D. Thegap G will allow air to flow proximally past the scraper 422.

As further shown in FIG. 30F, the scraper crown 420 can also include acut-out 426 formed in a sidewall thereof. One or more flange members 440can extend radially outward from a sidewall of the scraper crown 420 oneach side of the cut-out 426 formed through the crown 420 to define apathway. The flange members 440 can be positioned to axially align withthe a cut-out formed in the sorbent 414 and a cut-out formed in the lid418, as will be discussed in more detail below, to form a completepathway that allows the flow of insufflation gas from the insufflationport 406, through the cut-outs, and to the working channel 408 into thedistal cannula 404. This allows insufflation to be delivered through thecannula while an instrument is passed through the fluid remover 430 andoccludes the working channel. The flange portions 440 can be positionedon either side of an opening of the insufflation port 406, through whichthe insufflation gas flows. As a result, a pressure on each side of thefluid remover will be equalized.

The shaped scraper lid 418 is shown in more detail in FIGS. 301 and 30J,and it can have a generally circular or ring-shaped configuration thatrests proximal to the scraper. In use, the lid 418 can serve to protectthe proximal surface 432 of the scraper 422 from the insertion of sharpsurgical instruments by acting as a guide or funnel for the surgicalinstrument into the opening 424 of the scraper 422. As indicated above,the scraper lid 418 can include one or more holes 418h formed in adistal surface thereof for receiving the pins 436 formed on the crown420. The scraper lid 418 can also include an opening 418o through whicha surgical instrument can extend that is in axial alignment with theopening 424 formed in the scraper 422, and a cut-out 448 formed in asidewall or perimeter of the scraper lid 418 that aligns with thecut-out 446 formed in the scraper crown 420 and the sorbent 414.

As shown in FIG. 30J, in one embodiment the scraper lid 418 can furtherinclude a circular bead or compression ridge 450 protruding distallybeyond a distal-most surface thereof such that the ridge extends towardand presses against the proximal surface of the scraper 422 to hold thescraper 422 in controlled compression between the compression ridge 450on the lid 20 and the proximal surface of the crown 420. The compressionridge 450 can also function to seal off and prevent fluid from flowingback toward the opening of the scraper 422.

While there can be many configurations for the fluid remover 430, in theembodiment shown in FIGS. 30B-30E, the fluid remover 430 also includes asorbent 414 positioned circumferentially around the scraper crown 420and configured to sorb fluid scraped by the scraper 422. As shown inFIG. 30F, the sorbent 414 can be configured to be positioned around thescraper crown 420, and thus can have a cut-out 444 formed therein thataligns with the cut-out 426 formed in the crown 420. The terminal endsof the sorbent 414 will thus abut the flange 440 on the crown 420. As aresult, the sorbent 414 will be substantially C-shape. The cut-out 444in the sorbent 414 will also allow air to flow all the way around theoutside of the scraper 422, due to the gap G between the outer perimeterof the scraper 422 and the housing. The cut-out in the sorbent 414 willthus continue to allow air to pass by and around the scraper 422 in theevent the sorbent 414 becomes clogged. This is particularlyadvantageous, as air forced to flow through the sorbent 414 couldpotentially push fluid out of the sorbent 414. The sorbent 414 can besecured around the scraper crown 420 using any method known in the artincluding, for example, an adhesive or simply by an interference fitbetween an interior wall of the housing 402 and the scraper crown 420.As will be appreciated by those skilled in the art, the sorbent 414 canhave a solid ring shape, or any other shape, and it can be composed ofmultiple individual portions as needed.

While the sorbent 414 preferably has a shape that corresponds to theshape of the crown 420, the sorbent 414 can be configured to becompressed between the crown 420, the scraper 422, and the housing 402.Thus, the sorbent 414 can have an initial cross-sectional shape that ismore square and it can deform into a shape that is more triangular. Thesorbent 414 can be formed from various materials that allow it to becompressed, while still allowing the sorbent 414 to sorb fluid. Thesorbent 414 can also be permeable such that air can flow therethrough.

The particular size of the sorbent 414 can also vary, but in anexemplary embodiment the sorbent 414 has an inner diameter that isgreater than a diameter of the opening 424 in the scraper, such that thesorbent 414 will only contact the scraper 422 at a location radiallyoutward of the opening 424. This will allow fluid to flow from theopening, through the channels 422 c, and then sorbed by the sorbent. Inan exemplary embodiment, the sorbent is positioned radially outward ofthe holes 422 h formed in the scraper, as this allows the sorbent 414 tobe positioned around the crown 420.

As indicated above, when the fluid remover 430 is fully assembled, itcan rest within a distal portion of the proximal housing 402. Thesorbent 414 can be positioned in contact with an inner surface of thehousing 402, the crown 420 can be disposed within the sorbent 414, thescraper 422 can rest on the crown 420 and be positioned in contact withthe sorbent, and the lid can be positioned on the scraper 422 and bemated to the crown 420. The lid 418 can optionally be sonic welded orotherwise fixedly mated to the housing 402 to secure the fluid remover430 therein. As shown in FIG. 30F, the sorbent 414 can include surfacefeatures, such as longitudinally extending grooves 415 formed on aninner surface thereof and configured to align with and receive the pins436 on the scraper crown 420.

When disposed within the housing 402, the fluid remover 430 will bepositioned in the path of insufflation. In particular, referring againto FIGS. 30C and 30D, the insufflation port 406 has a lumen 460extending therethrough. The lumen 460 defines a longitudinal axis LA andhas a cylindrical interior surface with a proximal-most interior surface462 and a distal-most interior surface 464. The fluid remover 430 isgenerally positioned in the pathway of the lumen 460 and moreparticularly, it is positioned such that the proximal-most interiorsurface 462 of the lumen 460 is positioned distal to the scraper 422 andthe longitudinal axis LA extends through a mid-portion of the sorbent414. In other words, the sorbent 414 is positioned in the path of theflow of gas from the insufflation port 406 to the distal cannula. Aperson skilled in the art will appreciate that the various components ofthe fluid remover 430 can be positioned at various locations relative tothe insufflation port 406. Since portions of the fluid remover 430 inthe illustrated embodiment are positioned in the pathway of air flowfrom the insufflation port 406 to the distal cannula, the cut-outs 426and 444 in the crown 420 and sorbent 414 will allow airflow to passtherethrough and into the distal cannula.

In use, a surgical instrument can be inserted through the seals 412, 410and through the opening 470 in the fluid remover 430 as needed in aparticular procedure. Using the insufflation port 406, insufflation gascan be introduced into the working channel 408 of the trocar 400 suchthat insufflation is achieved distal to the seals 412, 410 and to thefluid remover 430. The insufflation gas can travel along the pathwaydefined by the flange portions 440, through the cut-outs 426, 444 in thecrown 420 and sorbent 414, respectively, and into the working channel408 of the distal cannula 404. In this way, the fluid remover 430 can bedistal to the seals 412, 410 to remove fluid from instruments beingwithdrawn while allowing the flow of insufflation gas into the distalcannula. As a surgical instrument is withdrawn from the working channel408, fluid scraped from the surgical instrument by the scraper 422 flowsradially outward and is sorbed by the sorbent 414, thus keeping thefluid away from any instrument that may be reinserted into the workingchannel 408. The fluid remover 430 thus allows for the removal of fluidfrom a surgical instrument at a position distal to the seals 412, 410while also allowing the introduction of insufflation gas distal to boththe seals 412, 410. A person skilled in the art will appreciate thevariations possible for the positioning of seals and fluid removers toallow insufflation distal to both.

FIG. 31 illustrates another embodiment of a lid 418′ for use with afluid remover. In this embodiment, rather than including a cut-out 448formed in a sidewall of the lid 418 for allowing air to pass by the lid418 in a proximal direction toward the seals, the lid 418′ includes aplurality of holes or openings 448′ formed therein and positionedradially around a perimeter of the lid 418′. The lid 418′ can includeany number of holes at any location and having any size. The holes 448′are merely configured to prevent the fluid remover from forming a seal,if not needed, as it may be desirable to maintain a zero pressuredifferential across the fluid remover in order to prevent air fromforcing fluid out of the sorbent.

FIGS. 32A-32D illustrate yet another embodiment of a trocar 500 having afluid remover 530 disposed therein. As shown, the trocar 500 has aproximal housing 502 and a distal cannula 504 with a working channel 508formed through and extending between proximal and distal ends thereof.As shown in FIG. 32B, the housing 502 can include an instrument seal,such as a deep cone seal 512 (only a proximal rim is shown), positionedwithin a channel seal, such as a duckbill seal 510. A person skilled inthe art will appreciate that any number, type, and configuration ofchannel and/or instrument seals can be positioned within the housing502. The housing can also include an insufflation port 506 is formed inthe housing 502 for providing an insufflation gas to the working channel508.

In this embodiment, the fluid remover 530 differs from fluid remover 430described above in that it is positioned more distal relative to theinsufflation port. In general, the fluid remover 530 has an opening 570formed through a center portion thereof, in axial alignment with theworking channel 508, for receiving a surgical instrument. The opening570 can be effective to remove fluid from a surgical instrument uponinsertion and/or withdrawal therethrough. The fluid remover 530 ispositioned distal to the seals 512, 510 so that fluid can be removedfrom the surgical instrument before it is withdrawn through the seals512, 510 in order to prevent the deposit of fluid on the seals. As withfluid remover 430, fluid remover 530 can have a configuration thatallows the passage of insufflation gas from the port 506 to the distalcannula 504 even when an instrument is disposed through the fluidremover 530. In particular, in this embodiment the fluid remover 530 isgenerally positioned in the pathway of the lumen 560 of the insufflationport 506 and more particularly, it is positioned such that thelongitudinal axis LA of the lumen 560 extends through a substantiallycenter portion of the scraper lid 518. The proximal-most interiorsurface 562 of the port is thus generally aligned with a top wall 556 ofthe scraper lid 518. As shown in FIG. 32B, the scraper 522 is thuspositioned distal to the longitudinal axis LA of the lumen 560 and cangenerally be positioned in alignment with the distal-most interiorsurface 564 of the lumen 560. In other embodiments, the scraper 522 canbe positioned entirely distal or proximal to the distal-most interiorsurface 564 of the lumen 460. A person skilled in the art willappreciate that the fluid remover 530 can be positioned in any number ofways relative to the lumen 560.

Since portion of the lid 518 and the scraper 522 are positioned in thepath of insufflation, the lid 518 and scraper 522 in this embodiment caneach have a cut-out 548, 546 that is positioned within the pathway ofthe insufflation gas to allow the gas to flow into the working channel508, as shown in FIG. 32D. The cut-outs 548, 546 can align with thecorresponding cut-outs 526, 544 in the crown 520 and the sorbent 514,respectively, similar to the crown 420 and sorbent 414 discussed above.As further shown in FIG. 32D, the scraper lid 518 can also include a rimor flange 550 extending around a proximal portion thereof and locatedproximal to the cut-out 548 formed in the sidewall of the scraper lid518. As a result, the notch 546 is not a complete cut-out, but isdefined on three sides by two opposed notch side walls 552 a, 552 b, anda top wall 556 and thus the top wall 556 can optionally serve as aproximal, sealed boundary for the insufflation gas pathway that will bedescribed below. In an exemplary embodiment, the top wall 556 can bepositioned in alignment with the proximal-most interior surface 562 ofthe lumen 560 in the insufflation port.

Another exemplary embodiment of a trocar is illustrated in FIGS. 33A-39.As shown in FIG. 33A, a surgical access device or trocar 600 isprovided. While the trocar 600 can have many configurations, it cangenerally include a housing 602 with a cannula 604 extending distallytherefrom. The housing 602 and the cannula 604 can define a workingchannel 606 extending longitudinally through a center thereof forreceiving a surgical instrument. An insufflation port 612 can be coupledto one side of the housing 602 for providing insufflation to the trocar600. In some embodiments, a fluid removal system which can include ascraper, a wicking element, and/or a sorbent, can be disposed within thehousing 602. While the insufflation port 612 can be disposed at manylocations on the housing 602, in this particular embodiment, theinsufflation port 612 is positioned proximal to the fluid removal systemand offset from the working channel 606 such that insufflation gasintroduced into the housing by the insufflation port 612 passes distallythrough the fluid removal system to insufflate the cannula 604 and thebody cavity when a surgical instrument is disposed within the workingchannel. A seal system can also be disposed within the housing 602 toprevent the escape of insufflation gas.

The trocar 600 is illustrated in more detail in FIG. 33B. In someembodiments the housing 602, and optionally the cannula 604, can be asingle, integrally formed component, such as in some of the embodimentsdescribed above. In other embodiments, such as that illustrated in FIG.33B, the housing 602 can include a proximal housing 608 and a separatedistal housing 610 that couple together to form the housing 602. Theproximal housing 608 and the distal housing 610 can enclose the variouscomponents of the trocar 600, such as the seal system and the fluidremoval system. For example, the proximal and distal housings 608, 610can enclose a seal system that can generally include a zero-closure sealand an instrument seal, for example, a duckbill seal 616 and a deep-coneseal 618, respectively. The seal system can further include an innerseal retainer 626 for holding and forming a seal with the variousinternal components, as will be described in more detail below.

The proximal and distal housings 608, 610 can also enclose the fluidremoval system, which can be disposed distal to the insufflation port612. As noted above, and as shown in FIG. 33B and 38A, the fluid removalsystem can generally include a scraper 620 for scraping fluid from asurgical instrument inserted therethrough, a wicking element 622disposed on the scraper (shown in FIG. 38A) for transferring scrapedfluid away from the surgical instrument, and/or a sorbent 624 forretaining fluid away from the surgical instrument. Since theinsufflation port 612 can be disposed within the housing 602 at alocation proximal to the fluid removal system, in general, the fluidremoval system can have an insufflation pathway formed therethrough,indicated by arrow A in FIG. 33B, to allow the passage of insufflationgas from a proximal portion of the trocar 600 to a distal portionthereof so that the area below the sealing system, including the cannula604 and the body cavity, can be pressurized. The pathway can be offsetfrom the working channel 606 so that insufflation gas can pass throughthe fluid removal system even when a surgical instrument is disposedwithin and occludes the working channel 606 of the trocar 600. These andother aspects will be described in detail below.

The components of the housing 602 are illustrated in more detail inFIGS. 34A-35, and the proximal housing 608 is shown in detail in FIGS.34A and 34B. The proximal housing 608 can generally be a substantiallyrigid, hollow component designed to enclose and retain the seal systemand to receive the insufflation port 612 and stopcock 614. The proximalhousing 608 can have many configurations, but in the illustratedembodiment, it has a proximal endwall 632 with a sidewall 633 extendingsubstantially orthogonally and distally therefrom. The proximal housing608 can be generally open distally, without a distal endwall, to allowthe distal end to mate to the distal housing. A cavity formed in theproximal housing can house the various inner components of the trocar600 when the proximal housing 608 is combined with the distal housing610.

In some embodiments, the proximal endwall 632 can include an opening 628for receiving a surgical instrument therethrough and for defining theworking channel 606 extending along a central longitudinal axis of thetrocar 600. A substantially rigid, cylindrical central lumen 630 canextend from the opening 628 a distance into the proximal housing 608 todefine the working channel 606. The central lumen 630 can also serve toguide a surgical instrument into the seal system. One or more matingelements 648 can be formed in the proximal endwall 632 of the proximalhousing 608 for mating with an obturator for inserting the trocar 600into tissue.

The proximal endwall 632 and the sidewall 633 of the proximal housing608 can have an exterior surface 635 and an interior surface 634 thatcan have any shape as desired to provide the required interior space.The sidewall 633 can optionally include a bowed or distended portion 636having an opening or cut-out 638 for receiving the insufflation port612. The sidewall 633 can also include a distal rim 641 that isconfigured to mate with a corresponding proximal rim 664 (shown in FIG.35A) of the distal housing 610. The proximal rim 664 and the distal rim641 can be mated together using any technique known in the art,including but not limited to, interference fit, press fit, adhesive,fastener, etc. For example, the proximal housing 608 can include one ormore coupling members 640 for mating to the distal housing 610. Theillustrated embodiment includes four coupling members 640 each extendingfrom a coupling lumen 642. The lumens 642 can be integrally formed withand/or rigidly coupled to the interior surface 634 of the sidewall 633,and the coupling members 640 can extend distally therefrom. The couplingmembers 640 can be substantially rigid, elongate pin-like componentsthat are configured to be disposed within corresponding coupling lumens666 (shown in FIG. 35A) of the distal housing 610. When the couplingmembers 640 are mated with the lumens 666, a secure coupling can beformed between the proximal and distal housings 608, 610 by way of, forexample, an interference fit, a press fit, or an adhesive. A personhaving ordinary skill in the art will appreciate the variety of waysthat the proximal and distal housings 608, 610 can be mated together.

In one embodiment, each coupling lumen 642 can have a protrusion or rib643 extending radially outward therefrom, as shown in FIG. 34B. Whilethe ribs 643 can have many configurations, in the illustratedembodiment, the ribs 643 are rectangular shaped protrusions thatgenerally extend along a length of the coupling lumen 642. Two of theribs 643 located on one side of the cut-out 638 can be orientated towardone another and the other two ribs 643 located on the opposite side ofthe cut-out 638 can be oriented toward one another, as shown in FIG.34B. The ribs 643 can be configured to engage pads 693 formed on aflange 691 of the inner retainer 626 (shown in FIGS. 36 and 37A). Theribs 643 can prevent the inner retainer 626 from floating within theproximal and distal housing 608, 610 and can thereby ensure adequatecompression of the seals 616, 618 and the scraper 620 to maintain apneumo seal. In particular, the ribs 643 can ensure that the gap betweena proximal sealing flange 644 of the proximal housing 608 and a proximalretainer rim 680 of the retainer 626 is of an appropriate height toprovide the desired compression of the seals 616, 618 disposed withinthe gap. For example, when the proximal housing 608 is fully seated onand mated with the distal housing 610, a distal end 637 of each rib 643abuts and engages a corresponding pad 693 on the flange 691 of the innerretainer 626. The distance between the distal end 637 of each rib 643and the proximal sealing flange 644 of the proximal housing 608 can setthe gap between the proximal sealing flange 644 and the proximalretainer rim 680 of the retainer 626 (described in more detail below).In this way, the amount of compression on the seals 616, 618 seatedtherebetween can be predicted. Similarly, the length of the ribs 643 canalso set the gap between the inner retainer 626 and the distal housing610, thus controlling the amount of compression of the scraper 620, alsodescribed in more detail below.

The proximal housing 608 can also include features for retaining andsealing against the seals 616, 618. For example, in some embodiments,the proximal housing 608 can include a proximal sealing flange 644formed on an interior surface 646 of the proximal endwall 632, as shownin FIG. 34B. The proximal sealing flange 644 can be a substantiallyrigid cylindrical member having a diameter greater than a diameter ofthe central lumen 630, but less than a width of the proximal housing608. In general, the proximal sealing flange 644 can act with the sealretainer 626 to retain and form a seal with the duckbill seal 616 andthe deep-cone seal 618, as will be described in detail below.

The distal housing 610 can also have many configurations and oneembodiment is shown in more detail in FIGS. 35A and 35B. Similar to theproximal housing 608, the distal housing 610 can generally be asubstantially rigid, hollow component designed to enclose and retain thefluid removal system and to receive the insufflation port 612. Thedistal housing 610 can have many configurations, but in the illustratedembodiment it has a distal endwall 652 with a sidewall 654 extendingsubstantially orthogonally and proximally therefrom. The distal housing610 can be generally open proximally, without a proximal endwall, andthe sidewall 654 can define a cavity made for housing the various innercomponents of the trocar 600 when the distal housing 610 is combinedwith the proximal housing 608.

The distal housing 610 can also generally be configured for receiving asurgical instrument therethrough and it can be configured to mate withthe insufflation port 612 and the proximal housing 608. For example, thedistal housing 610 can include an opening 650 formed in its distalendwall 652 for receiving a surgical instrument therethrough and fordefining the working channel 606 extending into the cannula 604. In someembodiments, the distal endwall 652 and the sidewall 654 can have anexterior surface 656 and an interior surface 658 and can have any shapeas desired that provides the required interior space. The sidewall 654can optionally include a bowed or distended portion 660 that includes anopening or cut-out 662 for receiving the insufflation port 612. Thesidewall 654 can also include a proximal rim 664 that is configured tomate with a corresponding distal rim 641 (shown in FIG. 34B) of theproximal housing 608. The proximal rim 664 and the distal rim 641 can bemated together using any technique known in the art, including but notlimited to, interference fit, press fit, adhesive, fastener, etc. Forexample, the distal housing 610 can include one or more coupling lumens666 for mating to the proximal housing 608. The illustrated embodimentincludes four coupling lumens 666 each integrally formed with and/orrigidly coupled to the interior surface 658 of the sidewall 656. Thecoupling lumens 666 can be substantially rigid, hollow components thatare configured to receive corresponding coupling members 640 (shown inFIG. 34B) of the proximal housing 608 to securely mate the proximal anddistal housings 608, 610 together as described above.

The distal housing 610 can also include features for retaining andsealing against the scraper 620. For this purpose, the distal housing610 can include a distal sealing flange 668 formed on the distal endwall652. The distal sealing flange 668 can be a substantially rigidcylindrical member having a diameter greater than a diameter of theopening 650, but less than a width of the distal housing 610. Ingeneral, the distal sealing flange 668 can act with the seal retainer626 to retain and form a seal with the fluid removal system, as will bedescribed in detail below. In addition, the distal housing 610 caninclude a plurality of ridges 651 that are designed to seat and matewith the scraper 620 as will be described in detail below. The ridges651 can be formed integrally with a proximal surface of a wall 736extending from the floor of the distal housing 610, and can have highand low portions that define each ridge 651.

A cavity 670, shown in FIG. 35A, can be formed between the opening 650and the distal sealing flange 668 for seating the sorbent 624. Thecavity can have one or more ridges, for example, a plurality of ridges672 formed around an interior surface of the distal sealing flange 668for providing frictional engagement with the sorbent 624. The cavity 670can also include a plurality of features, for example, four nubs 671that extend proximally from the floor of the cavity 670 and that aredesigned to engage the sorbent 624 and press the sorbent 624 intoengagement with the scraper 620 as will also be described in more detailbelow. As will be appreciated by those skilled in the art, any sort offeature sufficient to press the sorbent 624 into engagement with thescraper 620 can be used within the cavity 670. The nubs 671 can beformed integrally with the distal housing 610 or can be coupled theretoby an adhesive or other fixation mechanism.

The distal housing 610 can optionally be integrally formed with thecannula 604. The cannula 604 can extend distally from the distal housing610 and can terminate distally in an angled portion that forms a distalpiercing tip 605 that facilitates entry through tissue into a bodycavity. In some embodiments, a longest point of the angled distal tip605 of the cannula 604 can be oriented relative to the distal housing610 such that it is aligned with the insufflation port 612, although itcan have any orientation desired. The distal housing 610 can also haveone or more suture loops or other suture tie down features 675 formedaround an outer perimeter of an exterior surface 656 thereof. Eachsuture tie down feature 675 can define an opening or pathway formedtherethrough for receiving suture to help better secure the trocar 600when it is disposed in tissue. The suture tie down feature 675, shown inFIG. 33A, can have any angular orientation relative to the angled distaltip 605 of the cannula 604, but in one embodiment, at least one tie downfeature 675 is offset by 90 degrees from the longest point of the angleddistal piercing tip 605. In other embodiments, the suture tie downfeature 675 can be positioned in line with the angled distal tip 605 ofthe cannula 604, or offset by 180 degrees therefrom.

While the seal system and fluid removal system disposed within thehousing 602 can have many different configurations, one exemplaryembodiment of these systems is shown in more detail in FIG. 36. As notedabove, the illustrated seal system includes a duckbill type channel seal616, a deep-cone type instrument seal 618, and an inner seal retainer626 for securing the sealing elements within the trocar 600. As will beappreciated by those having ordinary skill in the art, any suitablesealing combination can be utilized within the housing 602 that iseffective to maintain insufflation of the cannula 604 and the bodycavity during use. Thus, the sealing combination can generally includeboth a zero-closure seal and an instrument seal and/or a single sealthat is capable of both zero-closure and sealing around an instrument.In the illustrated embodiment, the deep-cone seal 618 is disposed withinthe duckbill seal 616 such that an instrument inserted into the workingchannel 606 through the opening 628 in the proximal housing 608 willencounter the deep-cone seal 618 first. Since it is positioned proximalto the duckbill seal 616, the deep-cone seal 618 will form a seal aroundthe surgical instrument before the surgical instrument encounters andopens the duckbill seal 616. In this way, insufflation can be maintainedduring insertion of the instrument into the trocar 600.

While there are various ways to retain the seals within the housing 602,in the illustrated embodiment, the seals 616, 618 are disposed withinand coupled to the seal retainer 626. The seal retainer 626 and theproximal and distal housings 608, 610 can generally function together toseal the working channel 606 by pressing and sealing against a perimeterof the seals 616, 618. In particular, as shown in FIGS. 36-37B, the sealretainer 626 can be a substantially rigid cylindrical component thatdefines a portion of the working channel 606 and seals the workingchannel 606 from a region in the housing 602 outside of and/orsurrounding the retainer 626. The seal retainer 626 fits within thehousing 602 and that can have a proximal end 706 and a distal end 702.The proximal end 706 can have an opening 700 that is substantially thesame diameter as an outer diameter of the retainer 626, although it canhave any diameter as necessary to accommodate the seals 616, 618. Thedistal end 702 can include a distal endwall 708 with an opening 704extending therethrough. The opening 704 can have any diameter as needed,for example, a diameter that is smaller than the outer diameter of theretainer 626, but at least large enough to receive a surgicalinstrument. The retainer 626 can have a sidewall 711 extending betweenits proximal and distal ends 706, 702. In some embodiments, the distalendwall 708 can include a plurality of ribs 707 extending radially fromthe opening 706, as shown in FIG. 37C. The ribs 707 can be configuredfor maintaining positive contact between the scraper 620 and the sorbent624.

As noted above, in some embodiments the seals 616, 618 can be retainedby and sealed between the seal retainer 626 and the sealing flange 644of the proximal housing 608. In particular, the retainer 626 can have aproximal retainer rim 680 that can engage a distal surface 682 of aflange 684 formed on the duckbill seal 616. The proximal sealing flange644 of the proximal housing 608 can engage the proximal surface 686 ofthe flange 688 on the deep-cone seal 618. As shown most clearly in FIG.33B, when the trocar 600 is assembled, the proximal retainer rim 680 andthe proximal sealing flange 644 compress together around the outerperimeter of the flanges 684, 688 and form a seal thereagainst such thatthe working channel 606 is sealed for the purposes of insufflation. Aswell, the proximal rim 680 and the sealing flange 644 can retain theseals 616, 618 within the housing 602. As noted above, the amount ofspacing between the distal end 637 of the ribs 643 in the proximalhousing 608 and the proximal sealing flange 644 of the proximal housing608 can be used, at least in part, to predict and control the amount ofcompression of the seals 616, 618.

As also noted above, at least a portion of the fluid removal system canbe retained by and sealed between the seal retainer 626 and the sealingflange 668 of the distal housing 610. In particular, the seal retainer626 can include a distal retainer rim 690 that can engage a proximalsurface 692 of the scraper 620. In addition, the distal sealing flange668 in the distal housing 610 can engage a distal surface 694 of thescraper 620. When the trocar 600 is assembled, the distal retainer rim690 and the distal sealing flange 668 compress together around the outerperimeter of the scraper 620 to form a seal thereagainst such that theworking channel 606 is sealed for the purposes of insufflation. As well,the distal rim 690 and the sealing flange 668 can retain the scraper 620within the housing 602.

As shown in FIGS. 33B, 36, and 37A the seal retainer 626 can furtherinclude a median flange 691 extending radially outward from the retainer626 and disposed around an outer circumference thereof. The medianflange 691 can generally be disposed anywhere along a length of theretainer 626, but in the illustrated embodiment it is disposed near amid-portion of the retainer 626. The median flange 691 can be configuredto engage an inner sidewall of the proximal and distal housings 608, 610at a point where the proximal and distal housings 608, 610 matetogether. In this way, the retainer 626 can be retained and securedwithin the housing 602. As noted above, the flange 691 can also includea plurality of pads 693 configured to engage ribs 643 in the proximalhousing 608. The length of the ribs 643 can be used to predict andcontrol the compression of the seals 616, 618 and the scraper 620. Insome embodiments, the median flange 691 can have a portion 710 thatcurves or dips distally to accommodate the structure of the proximal anddistal housings 608, 610 near the coupling point for the insufflationport 612.

In some embodiments, the seal retainer 626 can also include a port 696for receiving the insufflation port 612. An opening 706 can be formed ina distal endwall 708 of the retainer 626 to allow insufflation gas toflow from the port 696 and through the distal endwall 708 to insufflatethe cannula 604 and the body cavity.

As noted above, the trocar 600 can include a fluid removal systemgenerally configured to remove fluid from a surgical instrument andtransfer and store the fluid at a location away from the working channel606 and any surgical instrument inserted therethrough. The fluid removalsystem can have many configurations, but as shown in FIG. 36, and asnoted above, it can include the scraper 620 having the wicking element622 formed thereon (shown in FIG. 38A) and the sorbent 624 positionedadjacent to the scraper 620 to sorb fluids wicked by the wicking element622.

The scraper 620 is shown in more detail in FIGS. 38A-38C and can haveany of the same or similar features and configurations previouslydescribed. The scraper 620 can be a substantially circular componenthaving a proximal surface 722 and a distal surface 694. An opening 712can be formed through a center of the scraper 620 for receiving asurgical instrument therethrough. The opening 712 can have a diametersubstantially the same as, or slightly smaller than, a diameter of asurgical instrument inserted therethrough so that the opening 712scrapes along the outside of a surgical instrument as it is passedtherethrough to remove fluid therefrom. As noted in the previousembodiments, the scraper 620 can be formed of a flexible material andcan therefore invert proximally as a surgical instrument is beingwithdrawn through and scraped by the opening 712.

There are many ways in which the scraper 620 can be retained within thehousing 602. As noted above, in one embodiment the scraper 620 can beretained by and disposed between the distal retainer rim 690 of theretainer 626 and the distal sealing flange 668 of the distal housing610. Because the scraper 620 can be formed of a flexible and/orcompressible material, as the rim 690 and the flange 668 engage theouter perimeter of the scraper 620, the outer perimeter of the scraper620 can be compressed therebetween and a seal can be formed between thescraper 620, the rim 690, and the flange 668. As noted above, the amountof spacing between the distal end 637 of the ribs 643 in the proximalhousing 608 and distal retainer rim 690 can be used, at least in part,to predict and control the amount of compression of the scraper 620. Theouter perimeter of the scraper can optionally include a lip 724extending proximally from the proximal surface 722. The rim 690 and theflange 668 can compress the scraper 620 at a location radially inward ofthe lip 722, as can be seen in FIG. 33B.

In some embodiments, the scraper 620 can include features to assist insecuring the scraper 620 within the housing 602. For example, theouter-most perimeter of the scraper 620 can include one or moreindentations, for example, four indentations 714 for receivingprotrusions 716 in the distal housing 610. The protrusions 716 arecoupled to and/or integrally formed with the lumens 666 and serve tofurther stabilize the scraper 620 within the distal housing 610. Thescraper 620 can also include an opening or hole 718 that can align withthe opening 706 formed in the retainer 626 to allow insufflation gas toflow therethrough. The hole 718 can have any size or shape known in theart that is sufficient to allow the flow of insufflation gastherethrough. In the illustrated embodiment, the hole 718 issubstantially rectangular and of a size to match the opening 706. Thehole 718 can be offset from the opening 712 such that an axis extendingthrough the center of the hole 718 that is parallel with thelongitudinal axis of the trocar 600 is offset a distance away from thelongitudinal axis of the trocar 600.

As noted above, the scraper 620 can also include features formedthereon, such as the wicking element 622, for wicking fluid away fromthe working channel 606. While the wicking element 622 can take any formsuitable to wick fluid away from the opening 712, in the illustratedembodiment, the wicking element 622 can be one or more channels 720formed in the distal surface 694. The channels 720 can extend partiallyinto the distal surface 694 of the scraper 620 and can have a depthsuitable to contain and transfer fluid away from the opening 712. Thechannels 720 can begin at the opening 712 and extend radially outwardtherefrom, or they can begin a radial distance away from the opening 712and extend radially outward therefrom, as shown in FIGS. 38A and 38C.Similarly, the channels 720 can extend all the way to the outer-mostcircumference of the scraper 620, or they can stop a distance away fromthe outer-most circumference, as shown in FIG. 38A. A person skilled inthe art will appreciate the variety of configuration possible for thechannels 720.

There can also be any number of channels 720 formed in the scraper 620as desired and they can be arranged around the scraper 620 with evenspacing therebetween and/or with uneven spacing therebetween. In theillustrated embodiment, a plurality of channels 720 are formed in thescraper 620 and the majority thereof are generally spaced evenly aroundthe scraper 620. However, channels 720 near the hole 718 can differ isspacing. For example, four of the channels 720 near the hole 718 are notspaced evenly with the other channels 720. Instead two channels 720 onone side of the hole 718 and two channels 720 on the other side of thehole 718 are spaced closer together to provide room for the hole 718 andto ensure that fluid is directed away from the hole 718. As noted above,the scraper 620 can be seated on the ridges 621 formed on the wall 736of the distal housing 610. In particular, the ridges 621 can engage anarrow circumference of the scraper 620 that is closer to the centeropening 712 than to the outer-most circumference, for example aboutone-quarter to one-third of the way along a length of the channels 720,although any configuration is possible. This narrow circumference ofengagement allows the scraper 620 to be seated within the distal housing610 without causing the channels 720 to buckle or collapse, as wouldlikely happen with a wider area of engagement. The channels 720 can bealigned with the ridges 621, as illustrated in FIG. 38C, such that eachchannel 720 is aligned with a low portion or valley of the ridges 621 toensure fluid flow through the channel 720. Each high portion or peak ofthe ridges 621 extends proximally between the channels 720. The channels720 can be adjacent to and in contact with the sorbent 624 to wick fluidto the sorbent 624.

The sorbent 624 can also have many shapes and configurations, as notedin detail above. In the embodiments illustrated in FIGS. 36 and 39, thesorbent 624 can be substantially c-shaped and/or substantially circularshaped with a cut-out 730 in one side. A center opening 727 of thesorbent 624 can have a diameter that is greater than a diameter of theworking channel 606 of the cannula 604 and/or of the opening 712 formedin the scraper 620. The sorbet 624 can have a proximal surface 726 and adistal surface 728, as well as an outer surface 732 and an inner surface734. The sorbent 624 can generally have a rectangular cross-section witha width W and a height H, and in some embodiments, the width W can beless than a height H. In other embodiments, the sorbent 624 can have acircular cross-section, a triangular cross-section, etc. The sorbent 624can generally have a size suitable to be positioned within the cavity670 formed within the distal housing 610. The cut-out 730 can have anywidth and configuration, and in the illustrated embodiment it has awidth similar to but larger than the size of the hole 718 in the scraper620 and the opening 706 in the retainer 626. For example, the cut-out730 can have a width larger than parallel walls 677 within the distalhousing 610 defining an insufflation pathway 674 through the distalhousing 610. The hole 718 in the scraper 620 and the opening 706 in theretainer 626 can have a width substantially the same as the width of thewalls 677 in the distal housing 610. The larger width of the cut-out 730compared with the width of the hole 718 and the opening 706 is to ensurethat the insufflation pathway remains clear of any fluid retained in thesorbent 624. In use, the cut-out 730 is preferably aligned with the hole718 and the opening 706.

As noted above, the sorbent 624 can be seated within the cavity 670 andon top of the nubs 671. The nubs 671 can engage the distal surface 728of the sorbent 624 and can elevate the sorbent 624 to bias the sorbent624 into engagement with the scraper 620. In particular, the proximalsurface 726 of the sorbent 624 can be pressed into engagement with thedistal surface 694 of the scraper 620. In some embodiments there can bea compression force that results in an interference contact between thesurfaces 726, 694 in the range of about 1/1000 to about 18/1000 inchesto ensure sufficient contact between the two surfaces 726, 694 withoutblocking the channels 720 and preventing fluid transfer. The engagementbetween the two surfaces 726, 694 provided by the nubs 671 results inefficient transfer of fluid from the channels 720 of the wicking element622 to the sorbent 624. Fluid scraped by the opening 712 can travelradially outward from the opening 712 through the channels 720, past theridges 621, and into contact with the sorbent 624 to be sorbed thereby.

When the trocar is assembled, all of the holes, openings, and pathwaysthrough the various components of the fluid removal system can bealigned to form an insufflation pathway through the fluid removalsystem, as shown by arrow A in FIG. 33B. More particularly, the sorbent624 can be positioned within the cavity 670 within the distal housing610. Ridges 672 can engage the outer surface 732 of the sorbent 624,while the inner surface 734 engages a wall 736 defining the opening 650that extends into the cannula 604. Opposed sides 738 a, 738 b of thecut-out 730 can be positioned on either side of the channel or pathway674 extending from the opening 650 within the distal housing 610. Thepathway 674 can be aligned with the port 696 of the retainer 626 toallow the insufflation gas to flow therethrough. The scraper 620 can bepositioned on top of or proximal to the sorbent 624 such that the outerperimeter of the scraper 620 rests on the distal sealing flange 668 ofthe distal housing 610, and such that the wicking element 622 isadjacent to and in contact with the sorbent 624. In this way, fluidscraped by the scraper 620 will be wicked along the channels 720 andsorbed by the sorbent 624. The sorbent 624 will hold the fluid away fromthe working channel 606, and thus away from any instruments insertedthrough the working channel 606. The hole 718 in the scraper 620 can bealigned with the pathway 674 in the distal housing 610 and with thecut-out 730 in the sorbent 624 to allow the flow of insufflation gastherethrough.

Further, the seal retainer 626 can be positioned proximal to the scraper620 such that the distal rim 690 is positioned on the proximal surfacein contact with the outer perimeter of the scraper 620 and forms a sealthereagainst with the distal sealing flange 668. The opening 706 in theretainer 626 can also be aligned with the hole 718 in the scraper 620,the cut-out 730 in the sorbent 624, and the pathway 674 in the distalhousing 610 to form the insufflation pathway to allow the flow ofinsufflation gas therethrough. In this way, insufflation gas from theport 696 passes from an area in the distal housing 610 that is proximalto the fluid removal system through the pathway created by the opening706, the hole 718, the cut-out 730, and the pathway 674 and into an areadistal to the fluid removal system. The insufflation gas can thereforepass into the cannula 604 and into the body cavity through the fluidremoval system even when a surgical instrument occludes the opening 712in the scraper 620.

In use, once the trocar 600 is inserted into a body cavity, theinsufflation port 612 can be used to introduce insufflation gas into thehousing 602 through the port 696 in the seal retainer 626. In otherembodiments, insufflation gas can be introduced into the housing 602before an instrument is inserted therethrough. The gas can flow into thechannel 740 in the retainer 626 near the distal end of the duckbill seal616 shown in FIG. 33B, and into the insufflation pathway created throughthe fluid removal system as described above, as well as through theworking channel 606. When an instrument is disposed through the trocar600, the deep-cone seal 618 forms a seal around the instrument tomaintain insufflation distal of the seal 618. Further, the surgicalinstrument occludes the opening 712 in the scraper 620, preventing theflow of gas through the working channel 606. The insufflation pathwaythat extends through the fluid removal system is offset from the workingchannel 606, and thus insufflation gas can flow through the insufflationpathway in the direction of arrow A, shown in FIG. 33B, as describedabove.

As a surgical instrument is withdrawn from the trocar 600, it is pulledthrough the opening 712 in the scraper 620. The opening 712 can scrapefluid from the outside of the surgical instrument. The fluid can travelinto the wicking channels 720 and be wicked away from the opening 712.The channels 720 can transfer the fluid to the sorbent 624, where it isheld away from the opening 712 so that any subsequently insertedsurgical instruments will not be contaminated by fluid. It will beappreciated by those having ordinary skill in the art that the order ofuse and/or method steps is not important and thus can be performed inany order.

In another embodiment, all of the above described fluid removerembodiments can be formed into a single “drop-in” unit as needed. Thedrop-in unit can include sorbent elements, scraper elements, wickingelements, and/or combinations thereof. These elements can be combined asneeded into an externally configured unit that can be placed into anexisting trocar system as needed. Thus, the drop-in unit will fit in andaround any seals and components disposed within the proximal housing,including the removable cap, and/or within the cannula. For example, thedrop-in unit can be configured to fit below or distal to one or moresealing elements and/or it can be configured to fit above or proximal toone or more sealing elements. Alternatively or in addition, the drop-inunit can be configured to have components that fit above, below, or inbetween sealing elements. The drop-in unit can also include the sealstherein such that the entire unit can be placed into an empty housing ofa trocar. The drop-in unit can also be removable as needed, and theunit, or portions thereof, can be reusable.

Methods for removing fluid from a surgical instrument are also generallyprovided. In an exemplary embodiment, a surgical instrument can bepassed through an access device and a fluid remover in the access devicecan remove any fluid on the instrument, or fluid deposited on a sealwithin the access device by the instrument. In one exemplary embodiment,a fluid remover can engage a surgical instrument passed through anaccess device, such as a trocar, upon removal of the instrument tothereby remove fluid from the instrument, thus preventing the fluid fromaccumulating on the seal(s) and/or from being redeposited on instrumentspassing therethrough. As indicated above, the fluid remover can beformed from any combination of one or more sorbing, scraping, andwicking elements. A person skilled in the art will appreciate thatvirtually any combination of sorbing, scraping, and wicking elements canform the fluid remover resulting in a variety of methods for removingfluid that can include any combination of sorbing, scraping, and wickingfluid away from a surgical instrument and/or from a seal or otherportion of a trocar or other access device.

A person skilled in the art will appreciate that the present inventionhas application in conventional endoscopic and open surgicalinstrumentation as well application in robotic-assisted surgery.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination. Byway of non-limiting example, the scraper and/or sorbent can be removed,cleaned, re-coated with a hydrophilic material, sterilized, and reused.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the devices described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and its contents are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

It is preferred that device is sterilized. This can be done by anynumber of ways known to those skilled in the art including beta or gammaradiation, ethylene oxide, steam.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is:
 1. A surgical access device, comprising: a housingdefining a working channel sized and configured to receive a surgicalinstrument; an insufflation port formed in the housing and configured todeliver an insufflation gas to the working channel; a seal disposedwithin the housing and positioned proximal to the insufflation port, theseal being configured to receive a surgical instrument passed throughthe working channel; and a fluid remover disposed within the housing andpositioned distal to the insufflation port, the fluid remover having anouter perimeter mounted within the housing and a central openingconfigured to receive surgical instruments therethrough, and the fluidremover being configured to allow insufflation gas to pass therethroughwhen an instrument occludes the central opening.
 2. The surgical accessdevice of claim 1, wherein the fluid remover comprises a scraperconfigured to scrape fluid away from surgical instruments insertedthrough the central opening.
 3. The surgical access device of claim 2,wherein the scraper includes a wicking element formed thereon andconfigured to wick fluid away from the central opening in the scraper.4. The surgical access device of claim 3, wherein the wicking elementcomprises a plurality of channels formed in a distal surface of thescraper and extending radially outward from the central opening suchthat fluid scraped off of a surgical instrument can flow into thechannels.
 5. The surgical access device of claim 2, wherein the fluidremover includes a sorbent disposed distal to the scraper and configuredto receive fluid scraped by the scraper.
 6. The surgical access deviceof claim 1, wherein the fluid remover includes a hole formed therein andpositioned a distance away from the central opening and the outerperimeter, the hole being configured to allow insufflation gas to passtherethrough.
 7. The surgical access device of claim 1, wherein thehousing comprises a proximal housing portion and a distal housingportion having a cannula extending distally therefrom, the proximal anddistal housing portions being disposed around an inner retainer, theworking channel extending through the inner retainer and the cannula,the outer perimeter of the fluid remover being in sealing engagementwith the inner retainer and the distal housing portion.
 8. The surgicalaccess device of claim 7, wherein the seal is captured between the innerretainer and the proximal housing portion.
 9. The surgical access deviceof claim 7, wherein the distal cannula includes an angled distal surfacehaving a distal-most point and a proximal-most point, the distal-mostpoint being aligned with the insufflation port.
 10. The surgical accessdevice of claim 1, further comprising at least one opening formed on anoutside wall of the housing and configured for receiving suture.
 11. Asurgical access device, comprising: a housing and a cannula extendingdistally from the housing, the housing and the cannula having a workingchannel extending therethrough between a proximal opening formed in aproximal end of the housing and a distal end of the cannula, the workingchannel being sized and configured to receive a surgical instrument; aninsufflation port coupled to the housing and configured to receive anddeliver an insufflation gas to the working channel; a seal disposedwithin the housing and configured to substantially prevent passage of aninsufflation gas from the insufflation port to the proximal opening whenno surgical instrument is disposed therethrough to; and a fluid removerdisposed within the housing and positioned distal of the seal, the fluidremover having an outer perimeter mounted within the housing, a centralopening formed therethrough and positioned to receive a surgicalinstrument passed through the working channel, and a hole formed thereinbetween the central opening and the outer perimeter, the hole beingconfigured to allow insufflation gas to pass from the insufflation portto the cannula when an instrument is disposed through and occludes thecentral opening in the fluid remover.
 12. The surgical access device ofclaim 11, wherein the fluid remover comprises a scraper configured toscrape fluid off of a surgical instrument passed through the opening.13. The surgical access device of claim 12, further comprising a sorbentdisposed within the housing at a location distal to the scraper, thesorbent being configured to sorb fluid removed by the scraper.
 14. Thesurgical access device of claim 13, further comprising a plurality ofnubs disposed within the housing and configured to push the sorbent intocontact with the scraper.
 15. The surgical access device of claim 12,further comprising a wicking element formed on the scraper andconfigured to wick fluid away from the central opening in the scraper.16. The surgical access device of claim 13, wherein the sorbent has acentral opening formed therethrough and axially aligned with the centralopening in the scraper, the central opening in the sorbent having adiameter greater than a diameter of the central opening in the scraper.17. The surgical access device of claim 11, wherein the insufflationport is positioned proximal to the fluid remover.
 18. The surgicalaccess device of claim 11, wherein the housing comprises a proximalhousing portion and a distal housing portion disposed around an innerretainer, the working channel extending through the inner retainer, theouter perimeter of the fluid remover being in sealing engagement withthe inner retainer, and the proximal opening being formed in theproximal housing.
 19. The surgical access device of claim 18, whereinthe inner retainer is captured between the proximal and distal housingportions.
 20. A fluid remover for use in a surgical access device thatincludes a housing defining a working channel sized to receive asurgical instrument, an insufflation port disposed in the housing, and aseal disposed proximal to the insufflation port, the fluid removercomprising: a fluid removing member having an outer perimeter and acentral opening formed therein for receiving and sealing around asurgical access device, the fluid removing member having a hole disposedradially outward from the central opening and radially inward from theouter perimeter and being configured to allow insufflation gas to passtherethrough.